title: Variation in refill protocols and procedures in a family medicine residency network.
abstract: OBJECTIVE
  Efficient and accurate medication refill authorization is an integral service provided by family physicians and an essential skill to teach family medicine residents. The goal of this study was to examine the variation in medication refill protocols, procedures, and resources in family medicine residency practices across a five-state region as a background for development of best practices.
  
  
  METHODS
  Structured telephone interviews with a key informant at each of 11 clinical practices in a five-state (Washington, Wyoming, Alaska, Montana, and Idaho) family medicine residency network focused on refill protocols and procedures, which personnel have authorization authority, and other factors related to refill protocols and medication prescribing curriculum. Key themes were abstracted from interview notes.
  
  
  RESULTS
  There was marked variation in refill protocols and procedures across the clinical sites. While all practices were able to identify their refill procedure, no two practices' procedures were the same, and only 36.4% had a formal written protocol that could be identified by the key informant. All of the practices with formal protocols routinely reviewed medical records before authorizing refills (100%, four/four) compared to less than half of those without formal protocols (42.9%, three/seven). Practices with formal protocols (75.0%) also transferred refill requests between staff prior to authorization more than those without formal protocols (57.1%).
  
  
  CONCLUSIONS
  Refill protocols and procedures were highly variable across these family medicine residency program practices. Surprisingly, formal written refill protocols were uncommon. Further research to identify best practices in medication refill procedures associated with safety outcomes is warranted.
authors.affiliation: Tacoma Family Medicine Residency Program, Tacoma, WA 98405-4238, USA. jguirgui@u. washington.edu
authors.forename: Janelle
authors.initials: J
authors.lastname: Guirguis-Blake
authors.forename: Gina A
authors.initials: GA
authors.lastname: Keppel
authors.forename: Rex W
authors.initials: RW
authors.lastname: Force
authors.forename: Jacintha
authors.initials: J
authors.lastname: Cauffield
authors.forename: Rob M
authors.initials: RM
authors.lastname: Monger
authors.forename: Laura Mae
authors.initials: LM
authors.lastname: Baldwin
mesh_terms: D002985:Clinical Protocols; D005194:Family Practice / Q000458:organization & administration*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D055553:Prescription Drugs
chemical_list: D055553:Prescription Drugs