Impact of a Targeted Recruitment Approach for a Medication Adherence Packaging Program.

Abstract

Background: Medication synchronization and packaging services have been shown to positively impact patient adherence, however lack of robust mechanisms to recruit and enroll patients can present barriers to their utilization.

Objectives: To assess the effectiveness of a systematically targeted approach to patient recruitment into a medication packaging program.

Practice description: An upper Midwest pharmacy chain, Lewis Drug, provides these services through two programs called SmartSync and SmartPack. Historically, there has been no targeted method for recruiting patients, leading to variable success of the programs.

Practice innovation: A targeted recruitment strategy was implemented identifying patients through pharmacy records including prescribed medications, adherence, and PioneerRx Risk Score, a composite score from 0-100 representing patient risk for hospitalization or medication therapy issues. Lead pharmacists from each of the eight intervention sites were provided patient lists for recruitment with recruitment instructions. Untargeted recruitment approaches continued to facilitate comparisons.

Evaluation methods: Patient data was described using counts, percentages, measures of central tendency, and data dispersion. Analyses for enrollment growth were conducted using an interrupted time series analysis, and within-group comparisons with Wilcoxon signed-rank Test. Chi-square analysis was used to test associations between groups and categorical variables.

Results: A total of 272 patients were identified. Of the patients with contact documented, 40% were enrolled. Of those enrolled, 81.4% were retained at 12 months. For risk scoring, statistically significant differences at 12 months compared to baseline were noted in recruited patients both for mean risk score reductions and shifts to lower risk categories. Adherence metrics remained high.

Conclusion: Overall, the targeted approach was successful in enrolling and retaining patients. Additionally, enrollment from untargeted recruitment approaches increased during the intervention, indicating the positive indirect effects targeted approaches can have on cumulative enrollment. Other pharmacy organizations may benefit from developing systematically targeted recruitment strategies for medication packaging programs.