Two Pharmacy Interventions to Improve Refill Persistence for Chronic Disease Medications

Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, SC 29425, USA.
Medical care (Impact Factor: 3.23). 02/2009; 47(1):32-40. DOI: 10.1097/MLR.0b013e3181808c17
Source: PubMed


Despite the proven effectiveness of many medications for chronic diseases, many patients do not refill their prescriptions in the required timeframe.
Compare the effectiveness of 3 pharmacist strategies to decrease time to refill of prescriptions for common chronic diseases. RESEARCH DESIGN/SUBJECTS: A randomized, controlled clinical trial with patients as the unit of randomization. Nine pharmacies within a medium-sized grocery store chain in South Carolina were included, representing urban, suburban, and rural areas and patients from a variety of socioeconomic backgrounds. Patients (n = 3048) overdue for refills for selected medications were randomized into 1 of 3 treatment arms: (1) pharmacist contact with the patient via telephone, (2) pharmacist contact with the patient's prescribing physician via facsimile, and (3) usual care.
The primary outcome was the number of days from their recommended refill date until the patient filled a prescription for any medication relevant to his/her chronic disease. Prescription refill data were obtained routinely from the pharmacy district office's centralized database. Patient disposition codes were obtained by pharmacy employees. An intent-to-treat approach was used for all analyses.
There were no significant differences by treatment arm in the study outcomes.
Neither of the interventions is more effective than usual care at improving persistence of prescription refills for chronic diseases in overdue patients.

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    • "Two articles (Blalock et al., 2010; Doucette et al., 2009) discussed difficulties that study pharmacists experienced when attempting to communicate with physicians. Finally, in a study involving refill reminders, 45% of the physicians contacted declined to participate (Nietert et al., 2009). Only one study described the processes through which pharmacy staff communicated with one another to coordinate service delivery (Berringer et al., 1999). "
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    • "In 38% (11/29) of the studies a change in medication adherence was not seen.17-20,26,27,29,31,35,43,47 In 24% (7/29) of the studies, an inadequate sample size to detect differences in adherence was identified as a limitation.19,24,25,28,29,35,43 The use of self-reported medication adherence was also problematic as baseline medication adherence was frequently higher than expected (patients often overestimate their adherence).22,26,28,29,35,43 "
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