Implementation of a community pharmacy workflow process to identify and follow up with prescription abandonment

Chancy, Patrick; Clifton, Cody L.; Branham, Ashley R.; Hayes, Harskin “Hj”; Moose, Joseph S.; Rhodes, Laura A.; Marciniak, Macary Weck

doi:10.1016/j.japh.2019.04.015

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…If a patient was at risk of PMN, they were randomized into a control or intervention group using a random number generator. The intervention group was contacted via phone by the study pharmacist who used an evidence-based protocol to support pharmacist–patient communication in order to identify barriers and create solutions to overcome potential PMN [ 19 ]. The control group was not contacted.…”

Section: Methodsmentioning

confidence: 99%

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A Pilot Study Exploring the Impact of a Primary Medication Non-Adherence Intervention among Four Chronic Disease States in One Regional Division of a Large Community Pharmacy Chain

et al. 2023

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There is a 12.2% rate of primary medication non-adherence (PMN) among community pharmacy patients. The Pharmacy Quality Alliance (PQA) has developed a standardized definition of PMN to aid stakeholders in addressing PMN. However, little research had been conducted to date on how to address PMN. The objective of the study was to determine the impact of an evidence-based adherence intervention program on PMN rates among four chronic disease states and to identify and characterize factors associated with PMN. Patients at risk of PMN were randomized into a control or intervention group. Those in the intervention group received a live call from a pharmacist to determine reason for and to discuss solutions to overcome PMN. Subjects included adult patients with newly prescribed medications used to treat diabetes, hypertension, hyperlipidemia, and/or chronic obstructive pulmonary disease (COPD). This study occurred in six pharmacies across one regional division of a national supermarket, community pharmacy chain. Prescriptions were considered newly initiated when the same drug, or its generic equivalent, had not been filled during the preceding 180 days. Prescriptions were considered at risk if they had not been obtained by day 7 of it being filled. Prescriptions were considered PMN if the patient had not obtained it, or an appropriate alternative, within 30 days after it was prescribed. During the 4-month intervention period, 203 prescriptions were included in the study with 94 in the intervention group and 109 in the control group. There was a 9% difference (p = 0.193) in PMN between the intervention group (44 patients, 47%) and the control group (61 patients, 56%). The therapeutic class most at risk of PMN was statins (34%). Cost (26%) and confusion/miscommunication (15%) were the most common reasons for PMN within the intervention group. Among the four chronic disease states studied, the intervention had the largest impact on hypertension. The PMN intervention did not significantly decrease PMN rates.

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Section: Methodsmentioning

confidence: 99%

“…The control group was not contacted. The protocol was adapted from the Drug Adherence Work-up (DRAW) Tool and the conversation flowchart used in P. Chancy et al [ 19 , 20 ]. The DRAW tool has been published as a resource to help reduce non-adherence, and has been primarily used to address secondary non-adherence.…”

Section: Methodsmentioning

confidence: 99%

A Pilot Study Exploring the Impact of a Primary Medication Non-Adherence Intervention among Four Chronic Disease States in One Regional Division of a Large Community Pharmacy Chain

et al. 2023

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“…The “Plan–Do–Check–Act” (PDCA cycle) was proposed by Dr Edwards Demingin the 1950s, this method divides the process of management into four parts, refers to the process of finding and solving problems in various areas of quality management. 6 It has been widely used for continuous improvement of medical quality, 7 As pharmacists have an important role in reducing medication waste throughout the pharmaceutical supply chain, 8 however, to our knowledge, no studies in China have been reported on PDCA reducing prescription abandonment. Therefore, we conducted a pharmacist-led PDCA at Tongde hospital of Zhejiang province, the main purpose was to analyze the influence factors in patients with prescription abandonment and the impact of pharmacist-led PDCA cycle.…”

Section: Introductionmentioning

confidence: 99%

Impact of Pharmacist-Led PDCA Cycle in Reducing Prescription Abandonment: An Action Research from China

Lv,

Sun,

Yang

et al. 2023

PPA

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Purpose Taking medicine as prescribed in time plays an important role in the treatment of diseases. However, some prescriptions have not picked up in time for various reasons. To analyze the influencing factors in patients with prescription abandonment and the role of pharmacists in Plan–Do–-Check–Act (PDCA) cycle, we conducted a study in our hospital of Hangzhou, China. Methods Based on the prescription abandonment from October 1, 2021 to March 31 2022, we collected and analyzed the possible causes. According to the PDCA management method, we conducted improvement measures and supervised the implementation of measures from April 1, 2022 to September 30, 2022. The number, the proportion and the amount of prescription abandonment before and after establishment of the PDCA cycle were analyzed. Results Three measures were proposed and applied to improve the prescription abandonment:(I) Enhancing the education and training to the staff. (II) Improving the medical environment for patients, especially the environment for taking medicine. (III) Updating the computer information software. After the implementation of PDCA, the number of prescription abandonment decreased from 2030 to 775, there was significant reduction in the proportion of prescription abandonment (4.75‰ vs 1.77‰, P<0.05), and the amount of prescription abandonment decreased from $36,161.11 to $17,041.59. The target compliance rate was 108.36%. Conclusion The implementation of pharmacist-led PDCA can effectively reduce the number, the proportion and the amount of prescription abandonment, Moreover, Pharmacists play an important role in improving the management quality of outpatient pharmacy, and PDCA is a feasible and effective management tool for reducing prescription abandonment.

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“…This non-adherence to medicine can lead to many problems, including an increase in morbidity and death rates [2]. One of the factors contributing to medicine non-adherence is prescription abandonment, which is defined as the inability of a patient to pick up their medicines from the pharmacy after they have been prepared [3]. Abandoned or unclaimed prescriptions are usually the terms used in research, but in this study, the term "uncollected medicines" will be widely used.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Uncollected Medicines at Two Health Centers in Brunei

Kifli

Ismail

Chua

2021

Asian J Pharm Clin Res

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Objective: This study was designed to achieve a better knowledge of uncollected medicines at two health centers in Brunei. Methods: Patients with prescriptions prepared at two community pharmacies but did not collect them within 1 week from March 2020 to April 2020 were included in this study. A telephone interview was conducted to discover why they did not collect their medicines. Results: A total of 43 patients completed the study, giving a rate of 0.85% uncollected prescriptions. A proportion of 24% of the uncollected medicines was cardiovascular drugs, 35% belonged to participants who forgot to collect their medicines, and 14% were uncollected due to participants being too busy. Conclusion: Further studies should be done to identify interventions that could decrease the number of uncollected medicines.

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Implementation of a community pharmacy workflow process to identify and follow up with prescription abandonment

Cited by 6 publications

References 5 publications

A Pilot Study Exploring the Impact of a Primary Medication Non-Adherence Intervention among Four Chronic Disease States in One Regional Division of a Large Community Pharmacy Chain

A Pilot Study Exploring the Impact of a Primary Medication Non-Adherence Intervention among Four Chronic Disease States in One Regional Division of a Large Community Pharmacy Chain

Impact of Pharmacist-Led PDCA Cycle in Reducing Prescription Abandonment: An Action Research from China

Prevalence of Uncollected Medicines at Two Health Centers in Brunei

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