ABM for ACO Beneficiaries

Study Overview
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Brief Summary
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The primary objective of the study is to evaluate how engaging ACO beneficiaries in the appointment based model for one year impacts medication adherence and healthcare costs compared to usual care.

Detailed Description
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The American Pharmacists Association (APhA) Foundation has partnered with a federally qualified health center (FQHC), a supermarket community pharmacy, and an accountable care organization (ACO) to participate in this ABM for ACO Beneficiaries initiative. The FQHC, El Rio Community Health Center pharmacy, and supermarket pharmacy, Fry's Pharmacy, will serve as implementing pharmacy study sites and will implement the ABM for beneficiaries of the ACO who utilize their pharmacies for medication refill services. The ABM involves synchronizing all medications to come due on the same day of the month and the individual receives a pre-appointment phone call from the pharmacy staff to review medications and identify any changes. The ACO will provide medical and claims data on enrolled subjects as well as a control group for the intervention population. The APhA Foundation will aggregate intervention, prescription fill, and economic data from the 3 partners in an effort to evaluate the impact of the ABM on healthcare costs and medication adherence. The APhA Foundation has an a priori intent to publish the project results.

Official Title
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Appointment Based Model (ABM) for Accountable Care Organization (ACO) Beneficiaries

Conditions
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Medication Adherence

Intervention / Treatment
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* Other: ABM


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Individuals eligible to be enrolled in the study include those who: Are beneficiaries of the partnering ACO; Are receiving medical care at El Rio and have been since before May 1, 2013; Are taking 2 or more medications that are refilled on 30, 60, or 90 day schedules; Speak English or Spanish; Are at least 18 years of age; and Are not institutionalized (i.e., residents of nursing homes, psychiatric institutions, or prisons). Exclusion Criteria: Use of a legal authorized representative

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ABM Intervention in FQHC<br>Pharmacy technicians within El Rio will implement the ABM | Other: ABM<br>* The ABM involves synchronizing all medications to come due on the same say of the month and the individual receives a pre-appointment phone call from the pharmacy staff to review medications and identify any changes.<br>* Other names: Appointment Based Model;|
| Experimental: ABM Intervention in a Supermarket Pharmacy<br>Pharmacists within Fry's will implement the ABM | Other: ABM<br>* The ABM involves synchronizing all medications to come due on the same say of the month and the individual receives a pre-appointment phone call from the pharmacy staff to review medications and identify any changes.<br>* Other names: Appointment Based Model;|
| No Intervention: Usual care<br>Patients will refill prescriptions at their usual pharmacy in the customary way. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medical costs | Total medical costs will be collected at baseline for the year prior to enrollment and at the end of the one-year study period for the intervention year. | Baseline (for the 1 year prior to the enrollment date), During the Patient Care period (approx. 1 year following enrollment) | 
| Pharmacy costs | Pharmacy costs will be collected at baseline for the year prior to enrollment and at the end of the one-year study period for the intervention year. | Baseline (at the time of enrollment), During the Patient Care period (approx. 1 year after enrollment) | 
| Medication adherence | Proportion of days covered will be calculated to determine medication adherence. Data will be collected on a quarterly basis (every 3 months beginning at enrollment). | At baseline for the one year prior to enrollment, During the 1 year patient care period | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Identified Medication Related Problems | Information regarding the type of medication related problem identified at each intervention point will be reported to the sponsor on a quarterly basis and during the Patient Care period. | During the Patient Care period (1 year from enrollment) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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adherence, healthcare costs, appointment based model, accountable care organization