(1174) Implementation of a Proactive Approach to Medication Refills in a Community Health Center

Objectives: Medication refill authorizations are often reactionary, creating a sense of urgency because a prescription has expired or a patient has run out of refills. Many healthcare systems utilize standardized protocols to respond to refill requests. However, these approaches often still result in interruptions in therapy, dissatisfied patients, and poor care team member experiences. Delays in response to refill requests may lead to medication non-adherence and suboptimal chronic care management.

A novel approach to the medication refill process was implemented within our health system to provide proactive medication refill management according to an approved protocol. Using an internal report, the medication refill pharmacist screened patients who were prescribed medication 50 weeks prior, identified those with eligible chronic medications, and provided refills for 30, 90, or 365 days based on the patient’s last visit and assessment of the condition for the prescribed medication, including vitals or lab monitoring parameters. The objective of this study was to evaluate the number and type of medication refills able to be proactively managed by the med refill pharmacist as well as to identify and categorize other medication-related problems worthy of intervention.

Methods: A retrospective review of proactive medication refills was completed between July 1, 2022 and June 30, 2023. Data collected for these medication refills included the total number of patients screened for proactive medication refills, number of medications refilled, length of refill authorized, number of prescriptions discontinued, and number and type of medication-related problems identified. All data was analyzed using descriptive statistics

Results: Of 8990 patients eligible for proactive medication refills, 8582 prescriptions were refilled before patients ran out of medication. Of these prescriptions, 1905 (22.2%) were authorized for 30 days, 4483 (52.2%) for 90 days, and 2194 (25.6%) for one year. A provider visit was required for continuity of care for 734 (8.2%) of these patients, while another 4093 (45.5%) patients needed vitals or lab monitoring. A total of 2288 medication-related problems were identified.

Conclusions: Proactive refilling of chronic medications by a pharmacist has the potential to anticipate patient needs, improve patient experience, optimize medication safety and adherence, and reduce care team workload.

Our results indicate that a majority of patients were only eligible for 30- or 90-day refills, with approximately half of patients needing follow-up and monitoring to ensure ongoing safety and efficacy with use of their medications. A large number of medication-related problems were also identified that would benefit from intervention but have no current process to be addressed. Collaboration between the med refill pharmacist and the clinical team could provide further opportunities to address gaps in care, minimize clinical inertia, prevent medication related adverse events, and improve patient experiences.