Automatic Refill Research Articles

Automated LPG Monitoring and Rebooking System using IoT- A Review

LPG (Liquified Petroleum Gas) has become an essential requirement in daily life, as many people rely on it for cooking, fueling vehicles, and more LPG offers a portable, clean, and efficient alternative to traditional fossil fuels, making it especially valuable for rural and urban areas in India. By replacing wood, coal, and other traditional fuels, LPG enhances health, air quality, and overall comfort. To simplify the LPG rebooking process for domestic and commercial use, various applications have been developed. This study presents a brief overview of existing research on LPG monitoring systems and proposes a method for automatic rebooking by monitoring LPG consumption in real-time and triggering an automatic refill request when the gas level reaches a predefined threshold. The system also provides users with notifications and updates about the status of the LPG, further enhancing convenience and reliability.

Automatic Low-cost Water Level Indicator for Tanks and Hand Washing Water Dispensers in Kitui; Kenya during the Covid 19 Pandemic

In day to day life, millions and millions of liters of water is being wasted through overflowing or excessive usage. In Kitui specifically, water availability by itself a challenge since the area rarely experiences long rainy seasons, has no flowing rivers, the dams are dry and there are only few boreholes available. It is for these reasons that we propose the adaptation of probe sensors to detect the water level in the hand washing water dispensers and storage tanks of the available boreholes in Kitui. The probe sensors detect the water level when they come in contact with them and in return a light emitting diode of the corresponding probe blinks. The system calculates the water level up to 100% by intervals of 25%. Moreover, the system is also connected to a relay switch that automatically turns on or off based on the water level. When each interval is reached, the light emitting diode blinks. At 25% the water level in the tank is lowest and this prompts the buzzer to produce a sound notifying the attenders that the tank needs to be refilled. An automatic refill also takes place due to the additional circuit connection. At 100% the relay goes OFF and water refill stops hence water wastage is avoided.

SAFETY, FEASIBILITY, AND ACCEPTABILITY OF TELEMEDICINE FOR HYPERTENSION IN PRIMARY CARE: A PROOF-OF-CONCEPT AND PILOT RANDOMIZED CONTROLLED TRIAL (SATE-HT)

Objective: Hypertension (HT) continues to be a leading cause of cardiovascular death and an enormous burden on the healthcare system. Although telemedicine may provide improved blood pressure (BP) monitoring and control, it remains unclear whether it could replace face-to-face consultations in patients with optimal BP control. We hypothesized that an automatic drug refill coupled with a telemedicine system tailored to patients with optimal BP would lead to non-inferior BP control Design and method: In this pilot, multicenter, randomized control trial (RCT), participants receiving anti-HT medications were randomly assigned (1:1) to either the telemedicine or usual care group. Patients in the telemedicine group measured and transmitted their home BP readings to the clinic. The medications were refilled without consultation when optimal control (BP <135/85 mmHg) was confirmed. The primary outcome of this trial was the feasibility of using the telemedicine app. Office and ambulatory BP readings were compared between the two groups at the study endpoint. Acceptability was assessed through interviews with the telemedicine study participants. Results: Overall, 49 participants were recruited in 6 months and retention rate was 98%. Participants from both groups had similar BP control (daytime systolic BP: 128.2 versus 126.9 mmHg [telemedicine vs. usual care], p = 0.41) and no adverse events. Participants in the telemedicine group had fewer general outpatient clinic attendances (0.8 vs. 2, p<0.001). Interviewees reported that the system was convenient, timesaving, cost saving, and educational. Conclusions: The system could be safely used. However, the results must be verified in an adequately powered RCT.

Safety, Feasibility, and Acceptability of Telemedicine for Hypertension in Primary Care: A Proof-of-concept and Pilot Randomized Controlled Trial (SATE-HT).

Hypertension (HT) continues to be a leading cause of cardiovascular death and an enormous burden on the healthcare system. Although telemedicine may provide improved blood pressure (BP) monitoring and control, it remains unclear whether it could replace face-to-face consultations in patients with optimal BP control. We hypothesized that an automatic drug refill coupled with a telemedicine system tailored to patients with optimal BP would lead to non-inferior BP control. In this pilot, multicenter, randomized control trial (RCT), participants receiving anti-HT medications were randomly assigned (1:1) to either the telemedicine or usual care group. Patients in the telemedicine group measured and transmitted their home BP readings to the clinic. The medications were refilled without consultation when optimal control (BP < 135/85 mmHg) was confirmed. The primary outcome of this trial was the feasibility of using the telemedicine app. Office and ambulatory BP readings were compared between the two groups at the study endpoint. Acceptability was assessed through interviews with the telemedicine study participants. Overall, 49 participants were recruited in 6 months and retention rate was 98%. Participants from both groups had similar BP control (daytime systolic BP: 128.2 versus 126.9 mmHg [telemedicine vs. usual care], p = 0.41) and no adverse events. Participants in the telemedicine group had fewer general outpatient clinic attendances (0.8 vs. 2, p < 0.001). Interviewees reported that the system was convenient, timesaving, cost saving, and educational. The system could be safely used. However, the results must be verified in an adequately powered RCT. Trial registration: NCT04542564.

Barriers and enablers towards benzodiazepine-receptor agonists deprescribing in nursing homes: A qualitative study of stakeholder groups

BackgroundDespite recommendations to deprescribe chronic benzodiazepine receptor agonists (BZRA) among older adults, the prevalence of their use in Belgian nursing homes (NHs) remains above 50%. The use of a behavioral science approach, starting with the evaluation of barriers and enablers for BZRA deprescribing, has the potential to decrease BZRA prescribing. ObjectivesTo identify barriers and enablers for BZRA deprescribing perceived by the different stakeholders involved in nursing home care in Belgium. MethodsIn a purposive sample of 6 NHs, we conducted face-to-face interviews with general practitioners (GPs), and focus groups with other healthcare providers (HCPs), including nurses, pharmacists, occupational therapists, physical therapists, and with NH residents and relatives. All interviews with HCPs were analyzed through deductive thematic analysis, using the theoretical domains framework (TDF) as the coding framework. Residents' and relatives' interviews were analyzed using an inductive thematic approach. ResultsWe interviewed 13 GPs, 35 other HCPs, 22 nursing home residents, and 5 relatives. Overall, 9 TDF domains were identified as most relevant among HCPs interviewed: Skills, Beliefs about capabilities, Goals, Memory attention and decision processes, Environmental context and resources, Social influences, Knowledge, Social/professional role and identity, and Beliefs about consequences. Five additional themes emerged from residents' and relatives' interviews: knowledge on medications used, communication with NH staff and GPs, perceived efficacy and necessity of BZRA, influence of the environment, and reluctance towards BZRA deprescribing. Some domains and themes differ between stakeholders (e.g., knowledge), while others match between groups (e.g., environmental aspects). ConclusionBZRA deprescribing is influenced by knowledge and skills gaps, automatic BZRA refilling, competing priorities, social challenges, environmental factors and poor nursing home residents involvement. Targeting these barriers will be a key step for implementation of BZRA deprescribing.

Automatic medication refills to improve glycaemic control among patients with diabetes and low medication adherence

BackgroundMedication adherence impacts health outcomes. Healthcare organisations implementing system-level interventions have potential for greater spread and sustainability than individual-level interventions. Within the integrated US Veterans Health Administration, a multidisciplinary team...

Automatic Low-cost Water Level Indicator for Tanks and Hand Washing Water Dispensers in Kitui; Kenya during the Covid 19 Pandemic

In day to day life, millions and millions of liters of water is being wasted through overflowing or excessive usage. In Kitui specifically, water availability by itself a challenge since the area rarely experiences long rainy seasons, has no flowing rivers, the dams are dry and there are only few boreholes available. It is for these reasons that we propose the adaptation of probe sensors to detect the water level in the hand washing water dispensers and storage tanks of the available boreholes in Kitui. The probe sensors detect the water level when they come in contact with them and in return a light emitting diode of the corresponding probe blinks. The system calculates the water level up to 100% by intervals of 25%. Moreover, the system is also connected to a relay switch that automatically turns on or off based on the water level. When each interval is reached, the light emitting diode blinks. At 25% the water level in the tank is lowest and this prompts the buzzer to produce a sound notifying the attenders that the tank needs to be refilled. An automatic refill also takes place due to the additional circuit connection. At 100% the relay goes OFF and water refill stops hence water wastage is avoided.

What lessons from Europe's experience could be applied in the United States in response to the opioid addiction and overdose crisis?

What lessons from Europe's experience could be applied in the United States in response to the opioid addiction and overdose crisis?

Noninvasive refilling of liquid marbles with water for microfluidic applications

Liquid marbles, liquid droplets coated with hydrophobic powder, have been emerging as a useful microfluidic platform. The ease of their synthesis and manipulation allows liquid marbles to serve as a robust microreactor. However, liquid marbles suffer the unavoidable problem of evaporation. Exposed to an environment with relatively low humidity, the liquid marble buckles and collapses due to evaporation. A suitably noninvasive technique to refill the liquid marble with water may open better opportunities for liquid marbles in microfluidics. To date, there has been no report on noninvasive methods for refilling the deflated liquid marble after the evaporation and subsequent buckling. This paper reports the noninvasive automatic refilling of liquid marbles using the concept of vapor transfer through porous media and subsequent condensation.

Improving Delays in Obtaining Lenalidomide at a Large Safety Net Hospital

Introduction:Lenalidomide is an immunomodulatory agent used primarily in the management of multiple myeloma and non-Hodgkin's lymphomas. Owing to the risks of birth defects and fetal death, lenalidomide is only available under a restricted program through Celgene called Revlimid Risk Evaluation and Mitigation Strategy (REMS). The Revlimid REMS program includes various requirements for patients and providers aimed to avoid embryo-fetal exposure from lenalidomide. Prescribers and patients are required to complete periodic mandatory surveys attesting that the patient is aware of the risks. Once the surveys are completed, a unique and time-limited authorization number is generated by Celgene, which must be included on the prescription. Each prescription is restricted to a 4-week supply with no automatic refills and must be sent to certified specialty pharmacy. In addition, the patient may require insurance authorization or may need to enroll in financial assistance program. Given this multi-step process, patients from our safety net hospital, LAC+USC Medical Center, experience delays in receiving their lenalidomide prescriptions. Such delays may lead to interruptions in cancer treatment and additional clinic visits. Our aim was to assess the effectiveness of the following interventions: creation of a standardized process flowchart, training of clinic staff, and additional patient support from Celgene to reduce delays in the dispensing of lenalidomide prescriptions.Methods:This is a retrospective study of patients prescribed lenalidomide through the hematology clinic at LAC+USC Medical Center, Los Angeles, CA from June 1, 2020 to December 31, 2020. Patients were identified through the Celgene REMS database. The electronic medical record was reviewed for: patient demographics, insurance, and specialty pharmacy dispensing of lenalidomide. Each prescription was reviewed for the authorization number, days from prescription submission to dispensing, and days between each prescription dispensing. A delay was defined as > 2 weeks from the time from prescription submission to pharmacy dispensing. The medical chart was reviewed to identify the reason for the delay.A standardized process was created between July 2020 and August 2020. This included the creation of a workflow flowchart and training of the clinic staff. Additionally, a patient access specialist from Celgene was assigned to support patients and providers through the multi-step process for each prescription. The percentage of pre-intervention delays (before Sept 2020) and post-intervention delays (after Sept 2020) was compared.Results:A total of 196 lenalidomide prescriptions were reviewed. Prior to the intervention, the median time from prescription sent to date of dispensing was 3 days (range: 0-27 days), with a mean time of 5.9 days. 14 of 128 prescriptions (10.9%) had a delay of > 2 weeks. Causes for delay included: awaiting completion of patient survey, insurance issues (need for prior authorization, insurance changes), clinic visit missed or not in correct timeframe to submit new prescription, hospitalization, and medication hold due to toxicity.Following the intervention, 3 of 68 prescriptions (4.4%) were delayed. Median time from prescription sent to date dispensed was 2.5 days (range: 0-29 days) with a mean time of 4.2 days. One prescription was not sent to the correct specialty pharmacy and one was on hold in setting of disease progression.Conclusion:Given the multi-step process, on-time dispensing of the specialty drug lenalidomide is a challenge at our safety net hospital. We identified several delays in the dispensing of lenalidomide prescriptions, including the timeliness of patient survey completion, drug coverage/insurance issues, and coordination of clinic visits with the time that the patient was due for the refill. Formalizing the workflow, training the clinic staff, and having a Celgene patient support specialist led to an improvement in prescription dispensing delays. With the continual addition of specialty medications into hematology/oncology clinics, establishing a standardized workflow with engagement of the clinic staff and specialty pharmacies/drug companies may help reduce delays in the dispensing of specialty drugs. [Display omitted] DisclosuresPiatek: Rigel: Consultancy, Research Funding; Alexion: Consultancy, Research Funding; Apellis: Research Funding; Dova: Consultancy, Speakers Bureau.

Monitoring and Feeding System for Pets

Over the years, more and more households are beginning to have pets. So, the most important issue recently was how to raise pets in an easy way. In today’s world, there is a growing focus on the regular interactions between human and physical devices. This paper introduces a smart pet monitoring and feeding system that is working in an environment of Internet of Things (IoT). Pet feeders came into existence as pet owners found it difficult to cater time to feed their pets. This system allows the owner to schedule and manage feeding times, portion sizes, and food supply for pets. They are controllable on smartphones using blynk and computers in order to feed them even when owners are away. The food dispensing mechanism is performed by the servomotor. It allows the user to monitor the pets using IP camera. A voice recording module is interfaced to the Arduino Uno with the owner’s voice recording for calling the pets at the meal time. Automatic water refilling has been designed and implemented along with the food dispenser.It offers new and developed way of feeding pets without the need of human intervention with refill alert and feeding alert. . Using smart pet feeder in houses will assure pet owners and increase comfort and peace of mind. Especially when we are unavailable for them.

The Role of Patient-reported Outcomes and Medication Adherence Assessment in Patient-focused Drug Development for Solid Organ Transplantation.

The Role of Patient-reported Outcomes and Medication Adherence Assessment in Patient-focused Drug Development for Solid Organ Transplantation.

An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients.

This international multidisciplinary consensus statement was developed to provide balanced guidance on the safe peri-operative use of opioids in adults. An international panel of healthcare professionals evaluated the literature relating to postoperative opioid-related harm, including persistent postoperative opioid use; opioid-induced ventilatory impairment; non-medical opioid use; opioid diversion and dependence; and driving under the influence of prescription opioids. Recommended strategies to reduce harm include pre-operative assessment of the risk of persistent postoperative opioid use; use of an assessment of patient function rather than unidimensional pain scores alone to guide adequacy of analgesia; avoidance of long-acting (modified-release and transdermal patches) opioid formulations and combination analgesics; limiting the number of tablets prescribed at discharge; providing deprescribing advice; avoidance of automatic prescription refills; safe disposal of unused medicines; reducing the risk of opioid diversion; and better education of healthcare professionals, patients and carers. This consensus statement provides a framework for better prescribing practices that could help reduce the risk of postoperative opioid-related harm in adults.

Developing an Automated Feeding System for Distributing Concentrated Goat Feed

Highlights An automatic feeding system, employing a suspended-type feed dispenser and capable of detecting different zones and accordingly adjusting the quantity of feed distributed, was designed for distributing concentrated feed to goats.The assigned tasks were satisfactorily completed by the system with no major malfunctions or problems.The farmer of the test barn reported a 10% increase in lactation quantity with no additional labor.The automatic feeding system is a means of resolving the labor shortage problem and achieving an improved feeding strategy for goat husbandry.Abstract. To resolve the labor shortage problem and to achieve better feeding strategy for goat husbandry in Taiwan, an automatic feeding system (AFS) was developed. Because of the relatively small scale of Taiwanese goat farms, goats at various growth stages are kept in the same barn but separated into zones. Different concentrated feed formulas are needed for goats at different growth stages. The majority of goat farms in Taiwan adopt elevated-floor-type barn. The zone-separating fences and the meshed floors hinder the application of walking-type feed dispenser. Corresponding to the farming conditions, the AFS was designed to use suspended-type feed dispenser and is capable of detecting different zones and adjusting the distribution proportion accordingly. This system comprises a feed bucket and distribution unit, a suspended feed bucket moving unit, and a sensor control unit. A programmable logic controller is used as the controller. Electric power needed to move the dispenser and to power other devices is translated through a conductor rail system, and the control signals are transmitted using wireless transceivers. The feed bucket incorporates two sub-buckets for different types of feed and distributes different proportions and quantities of feed at different times according to the feeding zone. A vibrating motor was used to prevent bridging and jamming of feeds inside feed buckets. The system was also equipped with ultrasonic sensors to detect the quantity of feed remaining in the buckets and proceeded with an automatic refilling procedure when the quantity remaining is too low. A maximum of 12 time periods for feeding can be scheduled daily. Functional tests results showed that the AFS could achieve the design goals, which include evenly dispensing various proportion concentrated feeds according to the zones, at several set disperser travelling speeds. The vibrating motor could realize zero feed remaining in the feed buckets. Field tests were carried out in a 55- × 10-m goat barn with 385 goats for six months. The barn was divided into six zones. Goats were fed 8 times per day, four times as much as compared to the conventional feeding scheme, with preset amounts of concentrated feed distributed per goat per meal. Field test results indicated that the AFS could satisfactorily fulfill the assigned tasks with no major malfunction or problem. In addition, the farmer of the test barn reported a 10% increase of lactation quantity with no additional labor after using the system for 1 year. This system proved to be feasible, have practical value and commercial potential. An extensive application of this system in the future is expected to resolve the labor shortage that besets goat farming. Keywords: Automatic, Goat farm, Labor saving, Smart agriculture.

Pharmacy patronage and service utilization: Associations with patient sociodemographic and health characteristics

ObjectivesThis study describes associations between patient sociodemographic and health characteristics, pharmacy patronage, and service utilization. DesignCross-sectional survey. SettingUnited States. ParticipantsA Qualtrics research panel was used to obtain a sample of American adults (N = 741) who had filled at least one prescription at a community pharmacy in the last 12 months. Surveys were completed electronically in January 2017. Main outcome measuresPrimary pharmacy patronage (chain, independent, grocery, mass merchandiser, or mail order) and utilization of pharmacy services. ResultsRespondents most commonly patronized chain pharmacies (51.6%), followed by mass merchandiser (17.1%), grocery (14.4%), and independent (11.0%) pharmacies. In multivariable analysis, geographic factors and age were the primary predictors of pharmacy patronage. Approximately one third (35.1%) of patients stated that their pharmacist knew their name. Being known by their pharmacists was significantly associated with patronage of independent pharmacies, long-term medication use, caregiving activities, and use of medication synchronization or adherence packaging services. Automatic refill (57.9%), e-mail or text reminders (37.4%), and influenza immunizations (26.7%) were the most commonly used pharmacy services surveyed. Younger patients were significantly more likely to report the use of medication synchronization and smartphone apps, whereas use of pharmacist-administered vaccination increased with age. Use of medication synchronization, home delivery, and adherence packaging services was higher among independent pharmacy patrons compared with chain pharmacy patrons. ConclusionThis study identified several sociodemographic and health-related predictors of pharmacy patronage and service utilization. Independent pharmacy patronage, caregiving activities, and utilization of some pharmacy services were associated with having an established patient-pharmacist relationship, as indicated by having a pharmacist who knew the patient’s name. Future research should explore how patient characteristics affect the use of pharmacy services and combinations thereof to facilitate targeted marketing of expanded pharmacy services to different populations.

Thermal management for a tube-shell Li-ion battery pack using water evaporation coupled with forced air cooling.

A novel battery thermal management system (BTMS) based on water evaporation (WE) and air-cooling (AC) for a tube–shell Li-ion battery (LIB) pack is designed. A sodium alginate (SA) film with a higher water content above 99% is fortified by adding polyethylene (PE) fibers. The air flow and PE-fiber composite sodium alginate (PECSA) film are both used to control the temperature of the battery pack. Results show that the maximum temperature of the battery pack can be controlled below 32 °C, when WE coupled with AC is used at a discharge rate of 1.8C within a discharge time of 1000 s. This method yields the highest performance of thermal management. The experimental results validate the numerical data, confirming that the design of WE combined with AC helps prevent overheating of a battery pack. This work also provides an automatic refilling system to solve the dehydration problem of the PECSA film.

Identifying Medication Management Smartphone App Features Suitable for Young Adults With Developmental Disabilities: Delphi Consensus Study.

BackgroundSmartphone apps can be a tool to facilitate independent medication management among persons with developmental disabilities. At present, multiple medication management apps exist in the market, but only 1 has been specifically designed for persons with developmental disabilities. Before initiating further app development targeting this population, input from stakeholders including persons with developmental disabilities, caregivers, and professionals regarding the most preferred features should be obtained.ObjectiveThe aim of this study was to identify medication management app features that are suitable to promote independence in the medication management process by young adults with developmental disabilities using a Delphi consensus method.MethodsA compilation of medication management app features was performed by searching the iTunes App Store, United States, in February 2016, using the following terms: adherence, medication, medication management, medication list, and medication reminder. After identifying features within the retrieved apps, a final list of 42 features grouped into 4 modules (medication list, medication reminder, medication administration record, and additional features) was included in a questionnaire for expert consensus rating. A total of 52 experts in developmental disabilities, including persons with developmental disabilities, caregivers, and professionals, were invited to participate in a 3-round Delphi technique. The purpose was to obtain consensus on features that are preferred and suitable to promote independence in the medication management process among persons with developmental disabilities. Consensus for the first, second, and third rounds was defined as ≥90%, ≥80%, and ≥75% agreement, respectively.ResultsA total of 75 responses were received over the 3 Delphi rounds—30 in the first round, 24 in the second round, and 21 in the third round. At the end of the third round, cumulative consensus was achieved for 60% (12/20) items in the medication list module, 100% (3/3) in the medication reminder module, 67% (2/3) in the medication administration record module, and 63% (10/16) in the additional features module. In addition to the medication list, medication reminder, and medication administration record features, experts selected the following top 3 most important additional features: automatic refills through pharmacies; ability to share medication information from the app with providers; and ability to share medication information from the app with family, friends, and caregivers. The top 3 least important features included a link to an official drug information source, privacy settings and password protection, and prescription refill reminders.ConclusionsAlthough several mobile apps for medication management exist, few are specifically designed to support persons with developmental disabilities in the complex medication management process. Of the 42 different features assessed, 64% (27/42) achieved consensus for inclusion in a future medication management app. This study provides information on the features of a medication management app that are most important to persons with developmental disabilities, caregivers, and professionals.

The Impact of the U.S. Drug Enforcement Agency Schedule Changes for Hydrocodone and Tramadol on California Prescriptions Patterns

The Impact of the U.S. Drug Enforcement Agency Schedule Changes for Hydrocodone and Tramadol on California Prescriptions Patterns

Horse-keeping practices in Australia: findings from a national online survey of horse owners.

To gain an understanding of general horse-keeping practices in Australia, including shelter, social contact, exercise, watering and supplementary feeding. An online survey was conducted with 505 owners in relation to one 'representative' horse in their care. The majority (83%) of horses were managed at pasture. Approximately one-quarter of those horses were housed alone (26%) or with one companion animal (27%). If horses were confined to a stable or small yard, the most recorded means of exercise was riding (65%) at a daily frequency (60%). Over half of the horse owners provided water in a trough or drinker with an automatic refill system (58%) and most horse owners supplied hay to their horses (82%), most commonly in combination with grazing. Areas of potential concern included one-quarter of stabled horses being prevented from unmediated social and physical contact with conspecifics and one-fifth of stabled horses being exercised less than daily. The horse-keeping profile in this study should be considered in the public communication of guidelines as well as interactions between veterinarians and clients.

Is the Currently Used Prescription Adjudication Date a Good Proxy for Calculating Medication Refill Adherence?

The Centers for Medicare & Medicaid Services (CMS) adopted the proportion of days covered (PDC) calculation for use in their Five-Star Quality Rating System for Medicare Advantage and Prescription Drug Plans. This calculation uses the prescription adjudication date (i.e., date the prescription is billed to the benefits manager by a pharmacy) as a proxy for medication adherence. Adherence programs, such as automatic refill programs, have become commonplace in community pharmacy and have been identified by industry leaders as interfering with the ability to accurately measure adherence using PDC. To evaluate the prescription pickup date instead of the currently used adjudication date to calculate PDC in the presence of a community pharmacy automatic refill program. This study used a post-only quasi-experimental design with patients aged 65 years or older enrolled in automatic and manual refill programs in a 29-store community pharmacy chain during 2014. PDC was calculated using the prescription adjudication date and pickup date (i.e., date the patient brought the medication home) using pharmacy dispensing data for CMS adherence metrics medications, including statins, renin angiotensin aldosterone system antagonists (RASA), and noninsulin diabetes medications. Mann-Whitney U and effect size calculations evaluated differences in PDC between automatic and manual refill prescriptions for the adjudication date and pickup date, as well as the difference in PDC between adjudication and pickup date. 10,936 prescriptions were included with 21.9% enrolled in the automatic refill program. Mean (SD) adherence was 88.6 (17.6) and 86.4 (17.1) for automatic refills and 85.8 (19.0) and 85.0 (18.9) for manual refills, using the adjudication date and pickup date PDC, respectively. Significant difference existed between automatic and manual refill prescriptions using the adjudication date (P < 0.001) but not for the pickup date. The difference between adjudication and pickup date PDC ranged from 0% to 32.0% for automatic refills and 0% to 38.7% for manual refills. The difference between adjudication and pickup date PDC was significant when comparing automatic and manual refill prescriptions (P < 0.001). The artificial inflation seen with adjudication date PDC indicates that the prescription pickup date is a more accurate reflection of patient medication taking. Automatic refills resulted in a less reliable PDC compared with manual refill prescriptions. Discussion about the continued use of the adjudication date to calculate PDC is needed. The project described was supported by the Clinical and Translational Science Award (CTSA) program through the NIH National Center for Advancing Translational Sciences (NCATS), grant UL1TR000427. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Lester is employed as a pharmacist in the pharmacy chain that participated in this study. The authors report no other relevant conflict of interest. Study concept and design were contributed primarily by Lester, along with Look and Chui. Lester took the lead in data collection, along with Look, and data interpretation, along with Look and Chui. The manuscript was written and revised primarily by Lester, along with Look and Chui.