OBJECTIVES: To examine the difference in the adherence of patients with metabolic syndrome receiving a hybrid model of care compared to other community pharmacy models. METHODS: Prospective, randomized-control trial design conducted through an integrated delivery network in Northwest Ohio. Patients required to have Paramount health insurance, type 2 diabetes, hypertension, hyperlipidemia, prescribed at least five oral medications, and prescribed an oral medication for each disease state. Patients randomly assigned to one of four groups. The first group received standard pill bottles. The second group received adherence packaging and refill synchronization. The third group received pill bottles and medication therapy management (MTM) using an appointment-based model. The fourth group received the hybrid model, including adherence packaging, refill synchronization, and MTM using the appointment-based model. Adherence was measured using patient-reported pill count.  RESULTS: The sample (n=26) was predominantly female, average age 61 years. Types of insurance included Medicaid(7.14%), Medicare(28.57%), and commercial insurance(64.29%). Adherence ranged from 29% to 100% among all participants. Interim, three-month results showed that the greatest improvement in medication adherence over time was seen in the hybrid model group, from 23.6% to 81.6%.  CONCLUSIONS: These preliminary results show that the hybrid model group has the potential to positively impact medication adherence. This is an ongoing study. Further results are needed to fully analyze the benefit of the hybrid pharmacy practice model of care.