Development of a Medication Refill System - A Collaboration Between Telemedicine and Pharmacy Departments

Stephen Denton, Delaney Cairns, Gabrielle Marchese, Adam Rich, Aditya Jadcherla, David Scott, Jacob Dyer, Rebecca Lundh, Staci Young, Rachele Harrison
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Abstract

Background: The Saturday Clinic for the Uninsured (SCU) has an on-site dispensary that provides free medications to patients. Many patients request urgent refills when they run out leaving them without medications prior to their appointments. A prior study showed a reminder phone call can effectively assist with medication refills.1 However, little data exists for how to develop such a system at a free clinic. Our team implemented this methodology utilizing a system where patients were contacted before their medications ran out to arrange refills and analyzed its effectiveness. Methods: All clinic patients receiving medications from the on-site dispensary had their expected refill date logged. Patients 3 weeks away from needing a refill had their chart reviewed to determine if they should be contacted. When indicated, patients were contacted one time via telephone by students to assess their needs and schedule refills. System outcomes were gathered over 18 weeks and analyzed to determine the number of potential medication gaps prevented and system success rate. Results: 131 patient charts were reviewed for potential follow-up. 58 patients were contacted, of which 32 patients were reached and spoken with resulting in 32 refills scheduled. The system prevented 24.4% of potential medication gaps with a system success rate of 55.2%. Conclusion: This system successfully reduced medication gaps among patients. The most and least effective methods for scheduling refills were by directly speaking with patients and leaving voicemails respectively. A trend observed was a decrease in urgent patient calls regarding medication gaps. Future directions include making multiple contact attempts, using multiple contact methods including texts and emails, and evaluating adherence.
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开发补药系统--远程医疗和药房部门之间的合作
背景:未参保者周六诊所(SCU)设有一个现场配药处,为患者提供免费药物。许多患者在药物用完后要求紧急补药,导致他们在预约前没有药物。之前的一项研究表明,电话提醒可以有效地帮助患者补药1。然而,关于如何在免费诊所建立这样一个系统的数据却很少。我们的团队利用该系统实施了这一方法,在药物用完之前与患者取得联系,安排补药事宜,并对其有效性进行了分析。方法:所有从现场药房领取药物的诊所患者都记录了他们的预计补药日期。在距离需要补药的日期还有 3 周时,医生会查看患者的病历,以确定是否需要联系他们。如有需要,学生们会通过电话与患者联系一次,评估他们的需求并安排补药时间。收集 18 周内的系统结果并进行分析,以确定防止潜在用药缺口的数量和系统成功率。结果:审查了 131 份患者病历,以进行潜在的跟踪。与 58 名患者取得了联系,其中 32 名患者接受了治疗,并与之进行了交谈,从而安排了 32 次补药。该系统防止了 24.4% 的潜在用药缺口,系统成功率为 55.2%。结论:该系统成功减少了患者的用药缺口。最有效和最无效的补药安排方法分别是直接与患者交谈和留下语音邮件。观察到的一个趋势是,患者因药物缺口而打来的紧急电话有所减少。未来的发展方向包括尝试多次联系、使用多种联系方法(包括短信和电子邮件)以及评估患者的依从性。
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