Two pharmacy interventions to improve refill persistence for chronic disease medications: a randomized, controlled trial

Med Care. 2009 Jan;47(1):32-40. doi: 10.1097/MLR.0b013e3181808c17.

Abstract

Background: Despite the proven effectiveness of many medications for chronic diseases, many patients do not refill their prescriptions in the required timeframe.

Objective: 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.

Measures: 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.

Results: There were no significant differences by treatment arm in the study outcomes.

Conclusions: Neither of the interventions is more effective than usual care at improving persistence of prescription refills for chronic diseases in overdue patients.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Assessment of Medication Adherence*
  • Chronic Disease / drug therapy*
  • Chronic Disease / ethnology
  • Clinical Pharmacy Information Systems
  • Directive Counseling / statistics & numerical data
  • Drug Utilization*
  • Humans
  • Insurance, Pharmaceutical Services
  • Medicaid
  • Medication Adherence / ethnology
  • Middle Aged
  • Outcome Assessment, Health Care
  • Pharmacies / organization & administration*
  • Program Evaluation
  • Proportional Hazards Models
  • Reminder Systems / classification*
  • Reminder Systems / statistics & numerical data
  • Socioeconomic Factors
  • South Carolina
  • Telefacsimile / statistics & numerical data*
  • Telephone / statistics & numerical data*
  • Time Factors
  • United States