Telephoning the patient's pharmacy to assess adherence with asthma medications by measuring refill rate for prescriptions

J Pediatr. 2000 Apr;136(4):532-6. doi: 10.1016/s0022-3476(00)90019-2.


Objective: To determine whether a prescription refill history obtained by telephoning patients' pharmacies identifies poor adherence with asthma medications more frequently than physician assessment.

Methods: The study population consisted of 116 children with persistent asthma who were Medicaid recipients; patients who received medication samples were excluded. During a clinic visit pulmonologists interviewed patients, caretakers, or both and estimated adherence on a checklist. A nurse asked the caretakers where they obtained medications and telephoned 66 identified pharmacies for refill histories. The maximum possible adherence was calculated as the number of doses refilled/number of doses prescribed x 100 for a mean duration of 163 days (range, 63 to 365 days). The accuracy of the refill information was determined from Medicaid reimbursement records.

Results: Information provided by pharmacies was 92% accurate. The mean (95% CI) of maximum potential adherence was 72% (65%,77%) for theophylline, 61% (55%,68%) for inhaled corticosteroids, and 38% (23%,53%) for cromolyn; only cromolyn and theophylline were significantly different. Physicians were able to identify 21 (49%) of 43 patients who refilled </=50% of prescribed doses of long-term symptom controllers and only 3 (27%) of 11 patients who used albuterol excessively.

Conclusions: Physicians often were unable to identify patients with very poor adherence. Checking prescription refills is an accurate and practical method of identifying such patients.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anti-Asthmatic Agents / therapeutic use*
  • Child
  • Drug Prescriptions* / statistics & numerical data
  • Female
  • Florida
  • Follow-Up Studies
  • Humans
  • Male
  • Medicaid
  • Patient Compliance* / statistics & numerical data
  • Pharmacies
  • Retrospective Studies
  • Telephone
  • United States


  • Anti-Asthmatic Agents