Q. What is adherence packaging?
Adherence packaging is a system that allows pharmacies to dispense medication in organized pouches or blisters that are customized to a patient’s specific medication regimen. The purpose of dispensing in adherence packaging vs. traditional bottles is to support patient medication adherence, making it easier for a patient to independently take the correct dose of their medication at the correct time of day.
Q. What are the benefits of adherence packaging?
Adherence packaging offers benefits for patients, providers, and pharmacies.
Pharmacists are supporting patients beyond the pharmacy counter and into their homes by securely multi-dose packaging medications that patients would otherwise be left to organize on their own. This support creates a simplified medication management system for patients that offers greater adherence, fewer errors, and better outcomes.
By reducing the time and resources needed to manage complex medication regimens, pharmacies with an adherence packaging focus create an environment where providers and the pharmacy team collaborate to reach patient health goals and quality metrics better. Providers want to work with pharmacies who understand how to manage medications for the chronically ill, and pharmacies are uniquely positioned to ensure that those living with chronic conditions are being provided services that better support their goals. This collaboration is not only better for the patient but can also increase measured quality metrics for providers and pharmacies.
Q. How do I determine if adherence packaging is right for my pharmacy?
Determining if adherence packaging is right for your pharmacy requires careful consideration of several factors, including:
Necessity: Do you have patients who are on complex medication regimens or are unable to manage their medications independently? Do you have providers in your area who are looking for enhanced pharmacy support? Are you looking for a competitive advantage in your town?
Staff: Can your staff manage adherence technology? Do you the time and resources for training? Will your team embrace the adherence technology?
Workflow and Procedure: Are you willing to look at pharmacy differently? Adherence packaging requires workflows and procedures, such as medication synchronization, that (once implemented) improve the pharmacy workday but takes time to organize and execute. This workflow is very different from a traditional ‘bill-and-fill’ workflow and requires pharmacy teams to think ‘outside the box’ about how patients are managed.
Marketing: You know all the benefits of adherence packaging, but patients and providers require education on why dispensing medication in multi-dose packaging can be a better option. As my dad told me when we were preparing to install our first adherence robot — “That machine is not going to sell itself.” Do you have relationships with providers you can educate on an adherence program? Do you have long-time patients you trust to ‘trial’ the packaging and provide you with feedback? Be sure to have a marketing plan in place to start and grow your adherence program.
Q. What types of patients are good candidates for adherence packaging?
The most successful adherence packaging patients are those whose medication regimen is simplified for them to take their medications independently in the home setting they choose. This includes patients with: multiple medications; complex chronic conditions; a history of medication non-adherence; and cognitive or physical impairments.
Q. How do I incorporate adherence packaging into pharmacy workflow?
As stated previously, incorporating adherence packaging technology into your pharmacy requires planning and preparation. Here are some tips to get started:
Choose the Right Technology: Research and select technology that meets the needs of your patient population.
Prepare Staff: The fact of the matter is your team may not be happy that you want to implement robots. Take time to listen to the concerns of your team, include them in the planning and preparation of the pharmacy and new procedures, and keep a positive work environment so they don’t feel as though their job is threatened.
Create a standard operating procedure. If you only formally create one document that outlines your adherence technology procedures, make it a standard operating procedure (SOP) to ensure consistency and efficiency in your workflow. Think about all the steps you take in your pharmacy today to fill a patient’s medication and what will be needed to switch from bottles to packaging. Some things you should be considering in your SOP’s are synchronization of medication, refills, billing, billing issues, and patient organization.
Market, market, market! Even before your technology is installed, start sharing that you will provide adherence packaging to patients you’ve identified as good candidates. Reach out to providers and ask if you can provide them with information on your program. Create a social media or print campaign that targets the population you want to reach.
Q. What training will my pharmacy staff need in adherence packaging?
Specific training requirements will depend on the type of technology you choose, but generally, the operations and safety of any adherence technology should be provided by the company you purchase your technology from. Your goal as a pharmacy owner is to make sure you have “buy in” from your team on your new technology and are providing your staff with what they need to educate patients on the technology, have discussions with providers who call and ask questions, and feel confident that adherence technology is the correct path for your pharmacy.
Q. How do I measure the success of my adherence packaging program?
Measuring the success of your adherence program is essential to evaluate its effectiveness and identify areas for improvement. Some of my go-to metrics to measure success include:
Quality Metrics: One of the primary goals of adherence packaging is to improve quality metrics. By closely following medication adherence metrics and CMS-measured metrics such as proportion-of-days-covered, you can determine success and use improved metric numbers to market your adherence program.
Medication Errors: Adherence technology can help reduce medication errors by improving the accuracy of medication dispensing.
Patient Satisfaction: The overall end user of your packaging system is the patient. You can survey patients to gather feedback on their experience with your program, including ease of use and overall satisfaction.
Workflow Efficiency: Adherence technology can help improve workflow by streamlining the dispensing process. You can measure workflow efficiency by tracking dispensing times, the number of prescriptions and/or patients, and the time it takes to operate the technology.
Return on Investment: Adherence packaging can be a valuable revenue stream for your pharmacy. Not only can you bring in new patients with marketing and unique partnerships, but you’d be surprised with how many of your patients don’t fill their entire prescription regimen at your pharmacy! The packaging not only gives you an opportunity to transfer in scripts that you may not be filling but also for billable clinical work such as Comprehensive Medication Reviews.
It’s also important to remember that needing adjustments or getting a bad review doesn’t mean the program is unsuccessful. Not every patient will be best supported with adherence packaging, and not every provider will like the technology you chose. That’s OK! You will learn more from the few negative interactions than if all were positive.
Q. How do I market my adherence packaging program?
Marketing your technology and adherence program is essential to ensure your community is aware of the service and understands its benefits. Some of my favorite strategies include:
Create Your Pharmacy's Pitch: Every team member in your pharmacy should know a 30-second blurb on the technology and its benefits. This message could be the same or different when speaking to patients vs. caregivers vs. providers but it should be an educational moment for the end-user when certain criteria are identified (such as a patient on six or more medications). Don’t forget that the team also needs to be able to follow up in more detail if required!
Display Signage: Posters, flyers, and floor stickers in high-traffic areas of your pharmacy, such as the waiting area and checkout counter, are a must. I also recommend stapling brochures to every prescription bag that leaves your pharmacy.
Collaborate With Healthcare Providers: Educating healthcare providers on your adherence technology can help providers identify potential patients that could benefit from your program. Identify specialty practices, home care agencies, and social worker groups in your community who you can reach out to.
Lindsay Dymowski Constantino, President & Cofounder of Centennial Pharmacy Services
Lindsay Dymowski Constantino is president and cofounder of Centennial Pharmacy Services, a leading LTC-at-home pharmacy; The Centennial Group, a pharmacy management firm; and The LTC@ Home Pharmacy Network, an organization supporting pharmacies in LTC-at-home. Combining her over 15 years of pharmacy experience with her entrepreneurial spirit, Lindsay knows exactly what drives successful pharmacies, launches collaborative provider programs, and gets the attention of payers — and it’s not dispensing medications. It’s how well you can support an organization’s goals to better health outcomes with patient-centric pharmacy care.
Passionate about the business of at-home pharmacy and its future in healthcare, Lindsay has presented at conferences, represented the industry in national media outlets, and currently sits on several boards committed to the advancement of the practice of pharmacy. Outside of the pharmacy world, Lindsay is a wife, a mother of two sons, and a novice gardener.
