Can prescription refill feedback to physicians improve patient adherence?
BACKGROUND
Although adherence to long-term drug therapy is an important issue, the means to facilitate its assessment and improvement in clinical practice remain a challenge.


OBJECTIVE
To evaluate the impact of prescription refill feedback and adherence education provided to primary care physicians.


METHODS
We provided 83 resident and attending physicians at a university-based general internal medicine practice with refill adherence reports on each of 340 diabetic patients. An educational session on adherence assessment and improvement techniques was held, and all physicians received a written outline on this topic. Physician attitude toward the intervention and 6-month change in refill adherence (doses filled/doses prescribed) of their patient panels were assessed. A nonrandomized comparison group of patients receiving hypertension medications for whom the physicians did not receive feedback was also evaluated.


RESULTS
The overall improvement in mean refill adherence was not significant (83.9% vs 86.0%, P=0.18). The educational session was attended by 53% of the physicians. The patient refill adherence of physicians attending the educational session improved by 5.0% (P<0.0009) with no significant change among patients of physicians not attending the session. There was no adherence change among patients for whom physicians did not receive refill feedback data, regardless of educational session attendance.


CONCLUSIONS
Patients of physicians that received refill feedback and attended an educational session improved their refill adherence. After replication of these results in a randomized trial, broad implementation of this approach could have substantial impact from a public health perspective, given the ubiquity of prescription claims data.
Schectman
Joel M
JM
Department of Medicine, University of Virginia, Charlottesville 22908, USA. js3dv@virginia.edu
Schorling
John B
JB
Nadkarni
Mohan M
MM
Voss
John D
JD
D001291:Attitude of Health Personnel; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005246:Feedback; D005260:Female; D006801:Humans; D007721:Knowledge of Results, Psychological; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D012923:Social Class; D014768:Virginia