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Background: The appointment-based model (ABM) is a framework for medication synchronization (med sync) which allows improved efficiency in pharmacy operations. Refill alignment forms the foundation of med sync programs and has proven to improve medication adherence. However it is uncertain if the remaining four components of ABM including the identification and enrollment of patients, medication review and patient assessment, preparation of medications, and delivery of medications can positively impact adherence., Objective: To identify ABM core component(s) that significantly improve medication adherence and evaluate the extent to what prescription volume utilizing ABM impacts adherence., Methods: A retrospective, cross-sectional analysis was conducted on 68 community pharmacies. Medication adherence rates were collected for antihypertensive, antihyperlipidemic, and oral hypoglycemic agents. Analyses were performed to determine the impact of ABM operations on adherence., Results: Four components of ABM were associated with significant improvement in adherence. The ABM operations related to those components include patient recruitment, medication delivery, flexible payment options, documenting synchronized medications and refill date, assessing patient ability to fill medications prior to refill date, refill timelines, and inquiring about medication changes during the patient outreach call (p < 0.05). While synchronizing at least 16% of a pharmacy's total prescription volume improved adherence, synchronizing at least 31% produced significant improvement across all chronic disease categories (p < 0.05)., Conclusion: Operationalization of four core components from the ABM process - identifying and enrolling patients, medication review and assessment, alignment of refills and preparation of medications - were all found to significantly improve adherence. Pharmacies wanting to improve adherence rates across chronic disease categories should aim to have a minimum of 31% of their prescription volume synchronized., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Many older adults are prescribed opioids and benzodiazepines (BZDs), despite increased susceptibility to adverse events. Challenges of deprescribing include fragmented care and lack of knowledge or time. Pharmacists are well-positioned to overcome these challenges and facilitate deprescribing of these medications., Objectives: We sought to evaluate interventions utilizing pharmacists to deprescribe opioids and BZDs in older adults., Methods: We conducted a rapid review following a comprehensive literature search to identify interventions with pharmacist involvement for deprescribing opioids and BZDs in older adults. Studies were included based on: (1) inclusion of patients ≥ 65 years old receiving BZDs and/or opioids, (2) evaluation of feasibility or outcomes following deprescribing (3) pharmacists as part of the intervention. We included randomized, observational, cohort, and pilot studies. Studies that did not report specific results for BZD or opioids were excluded., Results: We screened 687 abstracts and included 17 studies. Most (n = 13) focused on BZD deprescribing. Few studies focused on opioids (n = 2) or co-prescribing of opioids and BZDs (n = 2). The most common intervention was educational brochures (n = 8), majority being the EMPOWER brochure for deprescribing BZDs. Other interventions included chart review with electronic notes (n = 4), pharmacist-led programs/services (n = 2), and multifactorial interventions (n = 3). Many studies were underpowered or lacked suitable control groups. Generally speaking, interventions utilizing educational materials and those in which pharmacists engaged with patients and providers were more effective. Interventions relying on electronic communication by pharmacists were less successful, due to low acceptance or acknowledgement., Conclusions: We identified a number of feasible interventions to reduce BZD use, but fewer interventions to reduce opioid use in older adults. An optimal approach for deprescribing likely requires pharmacists to engage directly with patients and providers. Larger well-designed studies are needed to evaluate the effectiveness of deprescribing interventions beyond feasibility., (Copyright © 2021. Published by Elsevier Inc.)