Richmond, VA—Appointment-based medication-synchronization (ABMS) visits can go beyond just resolving drug-therapy issues and also include identification of needed vaccines and administration of them by community pharmacists, according to a new study.

Results of the retrospective observational study were published recently in the Journal of the American Pharmacy Association. Virginia Commonwealth University–led researchers evaluated comprehensive medication reviews documented by pharmacists during initial ABMS visits in 16 supermarket chain pharmacies in Central Virginia from September to December 2017.

The study team examined the documentation to compile information on patient demographics, medication therapy problems (MTPs), and recommended and administered vaccines. In addition, researchers collected data on disease states, number of medications synchronized per patient, and average time spent per initial ABMS visit.

MTPs were classified by:
• Adherence (overuse and underuse)
• Adverse drug reaction
• Cost-efficacy management
• Drug interactions (drug-drug/drug-disease)
• Excessive dose/duration
• The need for additional therapy (for chronic conditions)
• Suboptimal drug selection
• Unnecessary therapy

Within the study, 184 patients—118 women and 66 men—received an initial ABMS visit. The mean age was 70 years for women and 65 years for men, range 18 to 19 years (P <.08).

Disease states documented included asthma, benign prostatic hyperplasia, chronic pain, epilepsy, depression, diabetes mellitus, dementia, gastroesophageal reflux disease, history of myocardial infarction, human immunodeficiency virus, hyperlipidemia, and hypertension.

In the study group, women were found to have a significantly higher number of disease states than men (P <.03). The researchers identified 37 MTPs with no statistical difference between men and women (P <.98). 

Pharmacists reported spending an average of 17 minutes with patients during the initial visit, with an average of six medications synchronized per patient. At the same time, 637 vaccines were recommended and 51 were administered.

“Initial ABMS visit with a comprehensive medication review facilitated pharmacists in detecting medication therapy problems,” the authors conclude. “Although vaccines administered were lower than recommended, community pharmacists play an important role in preventive health through vaccine screenings and recommendations.”

Researchers said they are planning future studies to evaluate the outcomes of MTPs identified and resolved in the ABMS service.

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