Automating Adherence Packaging Improves Medication Management

Medication management is crucial to improving health outcomes, especially in long-term care facilities and inpatient care settings. But packaging prescriptions for the vulnerable population can be a challenge when patients have different needs and preferences.

“Medication management is a non-negotiable priority in long-term care, and the ability for technology to provide both blister and pouch packaging is revolutionary,” Donald Brindisi, pharmacy manager at Masonic Villages, a group of long-term care facilities in Pennsylvania, said in an interview with PharmaNewsIntelligence.

Masonic Villages serves over 2,000 residents across a retirement living community, a personal care facility, a children’s home, and a 453-bed skilled nursing and memory support facility.

Brindisi recently automated his pharmacy’s adherence packaging processes to meet patient needs and ensure long-term care patients take their prescriptions as ordered.

Patients may not take their medications because of cost, a mental barrier, or fear of an adverse side effect. But for seniors, forgetting about their medication is one of the top reasons for poor medication adherence, which can result in negative health outcomes. 

Adherence packaging can help patients keep better track of their medication by prepackaging a patient’s medications into blister packs marked with the time of day that it should be taken. 

A 2018 Innovations in Pharmacy (IiP) study found that patients reported improved medication adherence and improved outcomes when they used blister packaging. Although the blister packs helped patients on their own, they worked better when combined with medication therapy management sessions.

Brindisi’s pharmacy has worked with pouch packager solution ATP since 2012, leveraging the SmartCardRx prior to the current solution. The solution used light-to-fill tray that helped Brindisi’s technicians optimize their workflow, he said. 

“A pharmacist would fill all four cards at one time for once a month, then another pharmacist checked the light tray. But the footprint was smaller because the solution took up the whole counter and the technician would have to pull all the drugs to properly fill it,” Brindisi said.

“We worked through the kinks, but it was still tedious. It was now taking a tech an entire day and a half do fill the boxes.”

Once the first solution was coming to the end of its life around eight to ten years after implementation, Brindisi began looking at a solution that could do both blister and pouch packaging in an automated manner. The pharmacist went with Parata’s new product, ATP 2 Duo.

“It was a complete solution for all pharmacy automation where it does the multi-dose strip pouching. Once we went with the solution and the short cycle fill, it was a no brainer. We were close to fill-in, close to 12,000 pouches a week,” Brindisi said.

“It keeps inventory more controlled and streamlines workflow. It also creates a better footprint for the pharmacy in and of itself,” Brindisi added.

Automating both sides of adherence packaging is especially key to serving older and vulnerable patient populations.

About 40 percent of seniors take five or more prescription medications a day, but over 55 percent of seniors do not properly take these medications, according to a American Diabetes Association report.  

And year over year, the number of older adults in the US is increasing at a rapid rate. Last year, about 16.5 percent of the American population was 65 years or older. This number is expected to rise nearly five percent by 2050. 

When a patient 65 years of age or older has a complex chronic illness, they may have to maintain multiple therapies, which can be a challenging task. 

“The biggest advantage that we're getting right now is that the average resident is on at least 10 meds. If they're moving to more independent living, if we can sync all their meds up, it's going to be a huge win for everybody. That's the biggest advantage of med synchronization with med packs,” said Brindisi. 

Generally, a patient must go to the pharmacy three times a month to fill their prescriptions. But medication synchronization is a strategy that aligns the refill dates for multiple prescriptions. 

This eliminates the need for patients to call in multiple prescriptions and increases overall medication adherence, especially for older adults. 

Technology can help pharmacies address this challenge, and medication synchronization packaging, such as the solution that Brindisi leverages in his pharmacy, can improve medication management and even adherence for seniors.  

Overall, non-adherence affects nearly 50 percent of individuals who are prescribed medication for disease management, according to a 2018 National Institute of Health (NIH) report. And high levels of non-adherence have been linked to 100,000 deaths and $100 billion in preventable medical costs annually, researchers found.

Technology that can bring together blister and pouch packaging is helping pharmacists like Brindisi to address medication adherence while optimizing medication management workflows. But in the future, Brindisi believes technology will have the ability to focus on important data and uncover the patients who need more outreach, such as those who have complex medication regimens or have experienced non-adherence in the past. 

“Script patching may move towards automation, like a dispenser model where they take a week's worth of meds, roll them up, and put them in the machine. It then beeps to Mrs. Smith that, ‘Hey, take your meds,’ and if Mom doesn't take it, it sends a text message to power of attorney, son, or daughter and says, ‘Hey, Mom, didn't take her meds.’”

In the meantime, Brindisi is looking forward to leveraging adherence packaging automation to help thousands of residents.

“This adherence packaging is going to be a huge deal as our seniors age in place. There's a shortage of long-term care beds, or assisted living beds are becoming more and more full. You’re going to see more people aging at home with family members helping with their medications,” Brindisi concluded.