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


METHODS
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.
Nietert
Paul J
PJ
Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, SC 29425, USA. nieterpj@musc.edu
Tilley
Barbara C
BC
Zhao
Wenle
W
Edwards
Peter F
PF
Wessell
Andrea M
AM
Mauldin
Patrick D
PD
Polk
Pam P
PP
D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000188:drug therapy* / Q000208:ethnology; D016303:Clinical Pharmacy Information Systems; D037001:Directive Counseling / Q000706:statistics & numerical data; D004363:Drug Utilization; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D008484:Medicaid; D055118:Medication Adherence / Q000208:ethnology; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010594:Pharmacies / Q000458:organization & administration*; D015397:Program Evaluation; D016016:Proportional Hazards Models; D017010:Reminder Systems / Q000145:classification* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013022:South Carolina; D016636:Telefacsimile / Q000706:statistics & numerical data*; D013689:Telephone / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States; D016903:Drug Monitoring