Drug Refills Research Articles

Factors contributing to medication noncompliance in elderly public housing tenants.

A study examined the extent and correlates of noncompliance in 155 predominantly elderly public housing tenants. Data were gathered through in-home interviews; only data from tenants taking prescribed medications on a regularly scheduled basis (n = 140) were analyzed. Noncompliance was significantly (p less than 0.05) associated with taking more than five prescribed medications, an inability to read prescription and auxiliary labels, and difficulty opening flip-off type medication container lids. The results indicate that attempts to reduce the total number of prescription drug products used in these elderly residents by carefully scrutinizing the need for each prescription drug may enhance compliance. Pharmacists could assist in the detection of elderly patients at risk for medication noncompliance (five or more total prescription medications) by assessing the patients' ability to read labels on prescription containers for all new drug additions and refills, and by having them try to open a flip-off container lid.

Association between Appropriateness of Prescribing and Prescription Documentation

The association between the quality of physician prescribing and the degree of prescription documentation in the medical record was studied in four family-practice offices. Carbon-copy prescriptions were collected for five months at each office, and 438 were randomly selected for evaluation. For each prescription, a case abstract was prepared from the medical record. The abstract summarized the patient's previous care related to the problem for which the prescription was issued. The abstracts were blinded and randomly assigned for review by a panel of physicians and pharmacists working in family practice, resulting in a total of 1866 evaluations. Each panelist evaluated appropriateness of drug choice, potential benefit, and degree of prescription documentation. Actual prescription documentation of drug name, strength, quantity, directions, and refills was determined by comparing the carbon-copy prescription with the medical record. Multiple regression analysis revealed a significant correlation between panel evaluations for drug choice and actual documentation of drug name, strength, and directions. Likewise, the mean rating of potential benefit was significantly associated with actual documentation of drug name, strength, directions, and refills. The mean rating of appropriateness of documentation was significantly associated with all five independent documentation variables. Drug name, strength, and directions were recorded in 94%, 60%, and 75% of the medical records, respectively. These data demonstrate a positive association between the quality of prescribing and actual prescription documentation in the medical record.

Role of the Clinical Pharmacist in Improving Drug Therapy

We analyzed the effectiveness of clinical pharmacists in improving medical records and patient compliance with outpatient drug regimens. Records of patients followed up in a rheumatology and renal clinic were reviewed and compared with their pharmacy files. Records were evaluated for completeness and accuracy of drugs ordered by the clinic physician. Compliance was estimated by examining drug refills. This review was performed before (control group) and nine months after (study group) the introduction of a clinical pharmacist into the clinics. A six-month analysis demonstrates that the pharmacist significantly improved drug documentation, decreased the duplication of prescriptions, and improved compliance of prescribed drugs. The study suggests that the pharmacist improves documentation of drug therapy and estimated patient compliance; the decrease in duplicate prescriptions could prevent the risk of overdose and does reduce drug costs.