June 15, 2018
Inside: Pharmacy’s appointment-based model (ABM) is getting an update. See how adding clinical services to a model that already works can dramatically improve patient care.
Pharmacy’s appointment-based model (ABM) is getting an update. Adding clinical services to a model that already works can dramatically improve patient care.
With the appointment-based model, pharmacists synchronize patients’ chronic medication refills to a single appointment date. Typically, that means every 30, 60, or 90 days.
That approach has worked well. “Numerous studies show that the ABM increases medication adherence, which translates into more prescription fills per year for the pharmacy—a key driver of revenue in the current system,” said Lindsay Kunkle, Pharm.D., R.Ph., Senior Director, Practice Advancement & Pharmacist Engagement at the American Pharmacists Association (APhA).
But those traditional benefits are only the beginning. Appointments not only improve convenience and adherence, Kunkle said. They can also help identify and address gaps
in patients’ care.
Researchers studied 24 Kroger pharmacies with a total of 840 patients enrolled in an ABM program. It included 30-minute, in-person appointments. During the appointments, pharmacists assessed patients’ need for vaccinations, using their vaccination records if available, and offered appropriate vaccinations on the spot.
Vaccination rates in those pharmacies were nearly 25 percent higher than the control pharmacies that didn’t offer ABMs.
“With access to statewide immunization information systems, pharmacists can access a patient’s vaccine history, screen for and close gaps in immunization care, and contribute immunization information to empower the rest of the healthcare team,” Kunkle said.
These results not only introduce a new, lucrative, and effective service in the appointment-based model; they also point to the possibility of offering other services through an ABM.
“This study shows that adding patient care services, such as immunization screening and delivery, to the ABM can improve people’s health and increase patient and pharmacy staff satisfaction,” Kunkle said. “The ABM can be the platform upon which patient care services are delivered by optimizing workflow and freeing up the pharmacist to spend more time with patients.”
Patients even prefer the model. In the JAPhA study, more than 90 percent of patients said they would recommend the ABM program. And more than half said getting vaccinated at their appointment was convenient.
Besides the clear health benefits, patients also make fewer trips to the pharmacy and get one-on-one time with their pharmacist.
“It often does not take much convincing to get patients into the ABM because it can simplify their life, improve their care, and result in better health,” Kunkle said. “When you explain the ABM to patients who are on multiple chronic medications, they are often elated about the prospect of spending less time visiting and on the phone with the pharmacy.”
The ABM also reduces stress for pharmacy staff. Normally, pharmacists and pharmacy technicians react to calls and walk-ins throughout the day, which disrupts their workflow.
The ABM differs from simple medication synchronization with the calls to patients beforehand to identify changes, confirm refills, and answer questions.
“In the ABM, pharmacists and technicians take a proactive approach, resulting in fewer phone calls, more meaningful interactions with patients, prescribers, and insurers, and more focused time for pharmacists to provide patient care services,” Kunkle said. “With the shift to proactivity, many pharmacists and pharmacy staff members report being more satisfied employees.”
Some pharmacies also schedule appointment times for patients to pick up their medications. During these appointment times, pharmacists meet with patients to answer questions, offer consultations, perform comprehensive medication reviews, and provide other needed services.
Any pharmacy can put an ABM in place.
“Every pharmacy will need to evaluate their workflow and systems, their physical space, and patients’ preferences and needs as they implement the ABM,” Kunkle said. “The ABM does not require any fancy technology or other expensive modifications to be effective. But there are definitely components that can be added to create value and efficiency for patients and the pharmacy staff.”
For a detailed walkthrough on starting an ABM, check out the APhA Foundation’s implementation guide. It discusses how to phase in an ABM on top of current workflow, the materials needed, and other mechanics of the model.
When pharmacies offer immunization services as part of a scheduled appointment with patients, they can:
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