What’s in the box? A clear pathway to better health
Leo* was on track with his diabetes medication at first. But after a few months, the OneWorld pharmacy didn’t hear from him. He stopped refilling his prescription. He stopped returning calls.
Pharmacy staff didn’t know what happened, but they took notice of his absence.
When Leo next saw his provider, he was struggling. His A1C, which measures blood sugar levels over the past two to three months, was at a dangerously high 15.3. His provider alerted the pharmacy.
It was time to change tactics. Leo needed a different solution to help organize his medications and ease confusion – which would then free him up to focus on other aspects of his health.
Fortunately, the OneWorld Pharmacy has a program for patients like Leo. It’s called the Medication Unit-dose Packaging Program, and it’s a highly customized service that helps patients better understand which medication to take and when.
“Taking meds consistently makes a big difference. But also, less worrying about medications means more time to think about what they’re eating,” said Pharmacist Elizabeth Marquez, who heads up the program. “And as there starts to be some progress, patients gain momentum and might consider beginning to exercise. Those changes together can result in much improved outcomes.”
Participants in the Medication Unit-dose Packaging Program receive their medications packaged according to a personalized dosing schedule, with medications grouped into pouches that are to be used at designated times. Sometimes it’s referred to as the PASS Program, named after the robot that helps pharmacists package drugs correctly.
Marquez makes it sound easy, because that’s how the service should feel for patients.
It’s more complicated on the pharmacy side. First, staff need to determine eligibility of patients. Program participants must use OneWorld providers, be committed to taking their medications as prescribed, and have their prescriptions synchronized through the Med Sync program.
Plus, since the PASS program was implemented in 2021, pharmacists have fine-tuned the process as they learned more about how patients use it.
Key to the success of the program? Communication and commitment.
In the early days of the program, pharmacists noticed that patients sometimes became confused about when to open each packaged dose. Occasionally, patients returned to the pharmacy having skipped packages, or emptying pills loose into the medication box.
Marquez said a consultation appointment, paired with a contract that holds the patient and pharmacy accountable to each other, is now part of the process. At the consultation, Marquez said she and the patient open up the box and go through its contents in detail, to ensure understanding of the correct dosing schedule and use of individual pouches.
“It makes it more serious, it helps them to realize that this is something completely different from filling their meds in the normal flow of the pharmacy,” she said. “It gives us a chance to have some face-to-face interaction and build that rapport, so that they know they can trust me. It really eliminates any doubt about what the intention is and what the correct way to use [each medication].”
Currently, about 120 patients participate in PASS. More are in the process of being added, while still others are on the list for future enrollment. Setting up patients takes time – but the results are worth it.
After Leo re-committed to taking his medications as prescribed, the PASS program helped him stay on track and in communication with his providers. He was also able to dedicate more attention to other lifestyle changes to improve his health. At last check, his A1C had dropped to 7.3.
“With some patients, it’s really easy,” Marquez said. “For some, all it takes is someone being on their side – kind of looking out for them and simplifying it. Then things really fall into place.”