Coaching for Chronic Care


How on pharmacy helps patients with chronic concerns like diabetes.

As Ashley Duggins, PharmD was calling patients for monthly adherence check-ins, she discovered that one patient was several months overdue on filling her diabetes medications. Upon further discussion with the patient and a review of her prescription history, Ashley learned that the patient had recently adopted two foster children, one of which was a newborn. As she acclimated to her new role as a caregiver, the patient admitted to neglecting her own health and allowing her A1C to creep upwards.

headshot of Ashley Duggins, PharmD, owner and pharmacy manager of Prevo Drug

Ashley Duggins, PharmD, Prevo Drug Owner and Pharmacy Manager

This “coaching call” is just one example of how Owner and Pharmacy Manager Ashley and her team at Prevo Drug in Asheboro, North Carolina have transformed their pharmacy workflow to identify patients with chronic conditions who otherwise might fall through the cracks. Using Flip the Pharmacy resources as a blueprint, Ashley enrolled the patient in their adherence packaging program. Within two months, the patient’s medication adherence improved drastically and her diabetes became controlled.

“Our participation in Flip the Pharmacy has enhanced communication with patients and allowed us to focus more on chronic disease state management,” shares Ashley.

As a part of Flip the Pharmacy, Prevo Drug works on a team of community-based pharmacies to convert their business models away from point-in-time, prescription-level transactions towards patient-level, value-based care. Utilizing monthly change packages and coaching support, Flip the Pharmacy participants implement six key transformation domains over 24 months, such as leveraging the appointment-based model and establishing working relationships with other care team members.

Monthly calls are the foundation of a successful appointment-based model at a bustling pharmacy like Prevo Drug. Regular patient check-ins allow the pharmacy team to reconcile any medication changes, address adherence barriers, and schedule a pick-up time.

More complicated patients may be referred to Prevo Wellness, the pharmacy’s extension across the street with a focus on with preventative care, health education, and lifestyle changes. Patients can sign up for services including immunization screenings, diabetes education, and private health coaching for pre-diabetes, diabetes, high blood pressure, high cholesterol, and weight loss.

“Solid communication and open discussions with our patients have made all the difference in our practice,” Ashley says.

Patients who struggle with adherence are enrolled in Prevo’s adherence packaging program, where medications are organized by dose in individual pouches. Investing in automated adherence packaging technology has enabled Prevo to scale their medication synchronization program, where medication refills are scheduled for pick up at a single appointment time. Not only has this program improved medication adherence rates, it has also caught the attention of local physicians.

“Physicians and local health care professionals are starting to catch on,” Ashley points out. “With our adherence packaging program, they are noticing improved patient outcomes and referring patients to our pharmacy.”

Physicians are not the only ones who appreciate Prevo’s investment in automation. “Patients love it and so do caregivers. We see so many daughters and spouses of patients who are having a hard time. This program really takes the burden off them,” explains Ashley. Prevo Drug uses RxSafe for their pharmacy automation system, a proud sponsor of four Flip the Pharmacy teams. Additional funding for Flip the Pharmacy is donated by the Community Pharmacy Foundation, along with national and local team sponsors.

Ashley envisions community pharmacies of the future as health care triage centers with an emphasis on chronic care management. Following the Flip the Pharmacy model of enhanced communication and integration with providers, pharmacies will be better positioned to tackle more clinical aspects of care.

The Flip the Pharmacy program has over 1,000 community pharmacies actively engaged in practice transformation, which are supported by over 450 pharmacy coaches from 63 local Flip the Pharmacy teams and ten Technology Solutions Partners. To learn more, please visit and access the publicly available change packages, by clicking here.

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