title: Synchronized prescription refills and medication adherence: a retrospective claims analysis.
abstract: OBJECTIVE
  Medication adherence is often suboptimal, especially among patients on multiple chronic medications. We examined the association between synchronized medication refill schedules-which typically reduce organizational effort and logistical demands-and adherence.
  
  
  METHODS
  Retrospective study among patients enrolled in Medicare Advantage prescription drug plans.
  
  
  METHODS
  We used 2012 pharmacy, medical, and enrollment data linked with consumer meta-data for Medicare patients filling 2 or more maintenance prescriptions for antihypertensives, lipid-lowering agents, antidiabetic agents, antidepressants, and/or antiosteoporotic agents. Medication adherence for the year was measured using the proportion of days covered (PDC) at the drug class level. Patients were deemed adherent if drug class PDC was ≥0.80. Outcomes were compared between 1:1 propensity score-matched patients on synchronized versus nonsynchronized refill schedules for maintenance medications.
  
  
  RESULTS
  The synchronized refill group showed better adherence than the control group, although the magnitude of effects varied by drug class and specific outcome measure. Mean PDC scores ranged from 0.02 higher for antihypertensives to 0.07 higher for antidepressants in the synchronized refill group relative to the control group (P <.01). Further, compared with the control group, a larger proportion of synchronized refill group members were deemed adherent, ranging from 6 percentage points higher for antihypertensives to 15 percentage points higher for lipid-lowering agents (P <.01). Differences between the synchronized and control groups were larger among exclusive users of retail versus mail order pharmacies for maintenance medications.
  
  
  CONCLUSIONS
  Synchronized medication refill schedules were associated with better medication adherence, particularly for patients filling maintenance medications exclusively at retail pharmacies.
authors.affiliation: Economic Evaluations Unit, Center for Evidence-based Practice, Director, Value-based Insurance Design Initiatives, Center for Health Incentives and Behavioral Economics, University of Pennsylvania, 1223 Blockley Hall, Philadelphia, PA 19104. E-mail: jdoshi@mail.med.upenn.edu.
authors.forename: Jalpa A
authors.initials: JA
authors.lastname: Doshi
authors.forename: Raymond
authors.initials: R
authors.lastname: Lim
authors.forename: Pengxiang
authors.initials: P
authors.lastname: Li
authors.forename: Peinie P
authors.initials: PP
authors.lastname: Young
authors.forename: Victor F
authors.initials: VF
authors.lastname: Lawnicki
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Troxel
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Volpp
mesh_terms: D000368:Aged; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D020398:Medicare Part C; D055118:Medication Adherence; D012189:Retrospective Studies; D014481:United States