(1006) Does Delivery Service Impact Patient Reported Adherence for Patients Who Receive Adherence Packaging When Compared to In-person Pick Up?

Objectives: This study aims to evaluate the effect of delivery services on patient reported adherence to adherence packaging (medbox program) within a Federally Qualified Health Center (FQHC). Patients referred to the medbox program have difficulty with adherence and self-management of medications for multiple disease states. Many also struggle to pick up their medications at the pharmacy due to transportation barriers. Upon review of current literature, adherence packaging correlates with improved adherence. However, studies investigating delivery have mixed results depending on the patient population included. There is one study that investigated the impact of delivery on adherence rates for patients on adherence packaging which showed a positive correlation; however, the sample size was small. This study aims to add to current literature to determine if a delivery program provides additional improvements in adherence rates versus adherence packaging alone.

Methods: This study will be a pharmacist administered patient adherence survey. Patients will be included if they have been enrolled in the pharmacy medication adherence packaging program for at least 6 months. Patients who are less than 18 years old will be excluded. The primary outcome will be the difference in patient reported adherence rates between delivery and non-delivery groups. Secondary outcomes include delivery satisfaction and difference in portion of days covered (PDC) rates between delivery and non-delivery groups. Eligible patients will be given the opportunity to complete a 12 question online survey. The survey will be available in English or Spanish and will assess the patient’s reported adherence and satisfaction with delivery, if they receive it. After obtaining informed consent and screening for eligibility, the survey utilizes five adherence related questions, all obtained from the validated Brief Adherence Rating Scale (BARS). The remaining questions assess patient satisfaction with the services provided by the FQHC. The study window will consist of a four-month period from October to February 2024. In October 2023, a PDC value will be calculated for eligible patients’ adherence packaging over the last 3 months. This is defined as the percentage of days the patient has access to a day’s supply worth of medication in a given time period. It is calculated by determining the day supply of medication supplied to a patient divided by the total number of days, in this case 3 months. Patient data will be analyzed in 2 groups comparing survey responses and PDC values for those that receive delivery vs. those that pick-up medications in the pharmacy. Survey results that are continuous data points and average PDC will be analyzed via dependent samples t-test. Nominal outcomes will be reported as percentages and analyzed using chi-square analysis. Analysis will be done using Microsoft excel and GraphPad Prism.

Results: Data analysis will begin October 2023 pending IRB approval. There are around 800 patients who meet eligibility criteria. Due to previous low survey response rates in this patient population, 80 patients are anticipated to participate in the survey.

Conclusions: The results of this study will illuminate the impact of delivery on patient reported adherence when compared to in-person pick up for patients receiving adherence packaging. This study will be valuable in evaluating delivery satisfaction for patients in an FQHC. The results may be utilized to help other FQHCs make a determination regarding offering delivery services for patients receiving adherence packaging.