Refilling System Research Articles

The Predictors of Medication Adherence among TB Patients on the E-Refill Prescription System in Health Care Facilities in Lagos State

Background: Tuberculosis (TB) has continued to be a major health concern to man and has affected majority of the population around the world. In the World Health Organisation (WHO)’s estimate, Nigeria is second in Africa and seventh in the world with regard to cases. Since Lagos is the most populous state in Nigeria, it has made a high number of tuberculosis cases. Since there is no cure for TB without taking the prescription drugs, noncompliance has been as frequent as the disease, leading to treatment failure, drug resistant TB and increased cost of healthcare. The e-refill prescription system which is an electronic prescription refill system is targeted to increase medical compliance amongst TB patients consequently improving overall health.  Aim: The purpose of this study is therefore to evaluate the factors which determine medication compliance among TB patients on the e-refill prescription in health facilities in Lagos state.  Setting: Various healthcare facilities across Lagos.  Methodology: This study employed the cross-sectional method. For sampling, we opted for a purposive sampling approach to select the patients. The sample size, determined using the Kish formula, comprised approximately 338 TB patients. In order to collect data on critical factors such as patient’s satisfaction, factors influencing e-refill medication adherence, and the willingness to adopt the e-refill system, this study made use of in-depth interview and semi- structured question. Furthermore, the collected data was analysed with SPSS software, with two team members independently coding the interview transcripts to identify emerging themes and resolve discrepancies through consensus discussions.  Results: A large proportion of the participants fell between the ages of 28 to 38 years (45.9%), (53.0%) were married, and the Yoruba ethnic group dominated the population at (49.4%). Most patients received care from government- owned facilities (75.1%). 68.6% considered medical adherence important. Of factors influencing medical adherence, (47%) said that forgetfulness often affected their adherence, and (23.7%) cited the side effect. Of those surveyed, 54.4% expressed interest in using the e- Refill system, and 60.7% were knowledgeable about it. Ease of use (32.8%) and system trust (29.9%) are the main variables influencing readiness to utilise the e-Refill system.  Conclusion: The e-Refill system has shown potential for success in improving medication adherence among TB patients in Lagos state. However, it is important to address challenges such as limited access to healthcare and reluctance among certain patient groups need to be addressed. To get maximum result possible from the system, it is important to take steps to enhance patient engagement, address stigma associated with the illness, and ensure sustained support over the duration of the treatment.  Contribution: The study highlights the significance of niche interventions geared towards promoting medication adherence and improving TB treatment outcomes in resource-constrained environments.

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

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.

Strategies that enabled access to chronic care during the COVID-19 pandemic and beyond in South Africa.

The COVID-19 epidemic has revealed disturbing information about how chronic diseases are treated globally. Healthcare providers and coronavirus response teams have primarily reported on how individuals with chronic conditions sought care and treatment. However, individuals' experiences of patients are yet unknown. This study aimed to explore those strategies that enabled patients with chronic diseases access to chronic care and treatment during and beyond the COVID-19 pandemic. The study was conducted in the predominantly rural district of the Northwest Province, South Africa. An explorative qualitative research design was followed. Information-rich participants were chosen using a purposive sampling technique. Individual face-to-face interviews were used to gather data. Data saturation was achieved after interviewing n = 28 people in total. The six steps of Braun and Clarke thematic data analysis were used to analyse the data. The study revealed three themes, which includes improved healthcare structural systems, shift from traditional chronic care to digital care services and medication refill and buddy system. The findings of this study revealed a range of effective and noteworthy approaches that facilitated access to treatment and continuity of care. As a result, enhancing telemedicine as well as structural systems such as appointment scheduling, decanting choices, mobile and medication home delivery can improve access to care and treatment. The burden of disease and avoidable death will be eventually addressed by maximising the use of telemedicine and sustaining the new norm of ongoing care through digital and remote care and decanting strategies.

Changes in Attitudes to Medical Care among Pharmacy Pharmacists before and after the COVID-19 Pandemic: A Questionnaire Survey

The coronavirus disease 2019 (COVID-19) pandemic has had a major negative effect on the number of patients visiting pharmacies in Japan. The decrease in pharmacy visits during the pandemic compared with the pre-pandemic period may have increased the likelihood of adverse health outcomes; thus, it is important that pharmacy pharmacists take measures to prevent health disadvantages. In this study, we distributed a questionnaire survey to 104 pharmacy pharmacists (mainly in Kagoshima and Kumamoto Prefectures), and investigated changes in the extent of implementation and perceptions of measures considered necessary to protect patients' health between the pre-pandemic and pandemic period. The results showed that the proportions of respondents "sharing patient information between primary care doctors and pharmacy pharmacists" and conducting "follow-up after prescribing medications mainly via telephone" increased between the pre-pandemic period and September 2022. The perceived necessity of the above two measures, as well as "online medication instructions" and "a prescription refill system," increased during the same period. However, the proportion of respondents who perceived "0410 correspondence," which was introduced during the pandemic, as a necessity did not change. Moreover, many pharmacists indicated that, at their own discretion, they continued to correspond with patients in relation to the above, and to respond to specific requests during normal daily practice. Our results could help community-based pharmacists tackle serious public health problems, such as COVID-19.

Optimizing naloxone distribution to prevent opioid overdose fatalities: results from piloting the Systems Analysis and Improvement Approach within syringe service programs

BackgroundOpioid overdose fatalities are preventable with timely administration of naloxone, an opioid antagonist, during an opioid overdose event. Syringe service programs have pioneered naloxone distribution for potential bystanders of opioid overdose. The objective of this study was to pilot test a multi-component implementation strategy—the systems analysis and improvement approach for naloxone (SAIA-Naloxone)—with the goal of improving naloxone distribution by syringe service programs.MethodsTwo syringe service programs participated in a 6-month pilot of SAIA-Naloxone, which included (1) analyzing program data to identify gaps in the naloxone delivery cascade, (2) flow mapping to identify causes of attrition and brainstorm programmatic changes for improvement, and (3) conducting continuous quality improvement to test and assess whether modifications improve the cascade. We conducted an interrupted time series analysis using 52 weeks of data before and 26 weeks of data after initiating SAIA-Naloxone. Poisson regression was used to evaluate the association between SAIA-Naloxone and the weekly number of participants receiving naloxone and number of naloxone doses distributed.ResultsOver the course of the study, 11,107 doses of naloxone were distributed to 6,071 participants. Through SAIA-Naloxone, syringe service programs prioritized testing programmatic modifications to improve data collection procedures, proactively screen and identify naloxone-naïve participants, streamline naloxone refill systems, and allow for secondary naloxone distribution. SAIA-Naloxone was associated with statistically significant increases in the average number of people receiving naloxone per week (37% more SPP participants; 95% CI, 12% to 67%) and average number of naloxone doses distributed per week (105% more naloxone doses; 95% CI, 79% to 136%) beyond the underlying pre-SAIA-Naloxone levels. These initial increases were extended by ongoing positive changes over time (1.6% more SSP participants received naloxone and 0.3% more naloxone doses were distributed in each subsequent week compared to the weekly trend in the pre-SAIA Naloxone period).ConclusionsSAIA-Naloxone has strong potential for improving naloxone distribution from syringe service programs. These findings are encouraging in the face of the worsening opioid overdose crisis in the United States and support testing SAIA-Naloxone in a large-scale randomized trial within syringe service programs.

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How do contextual factors influence naloxone distribution from syringe service programs in the USA: a cross-sectional study

BackgroundNaloxone is a medication that can quickly reverse an opioid overdose. Syringe service programs (SSPs) are community-based prevention programs that provide a range of evidence-based interventions in the USA, including naloxone distribution. Attributes of SSPs make them ideal settings for naloxone distribution—they have staff and delivery models that are designed to reach people who use drugs where they are. We assessed which outer and inner setting factors of SSPs were associated with naloxone distribution in the USA.MethodsWe surveyed SSPs in the USA known to the North American Syringe Exchange Network in 2019. Using the exploration, preparation, implementation and maintenance framework, we assessed inner and outer contextual factors associated with naloxone distribution among SSPs (n = 263 or 77% of SSPs). We utilized negative binomial regression to assess which factors were associated with the number of naloxone doses distributed and people receiving naloxone.ResultsSSPs reported distributing 710,232 naloxone doses to 230,506 people in the prior year. Regarding outer setting, SSPs located in areas with high levels of community support had a higher level of naloxone distribution (aIRR = 3.07; 95% confidence interval (CI): 2.09–4.51; p < 0.001) and 110% (p = 0.022) higher rate of people receiving naloxone (aIRR = 2.10; 95% CI 1.46–3.02; p < 0.001) in the past 12 months. The legal status of SSPs and the level of need was not significantly associated with naloxone distribution. Regarding inner setting, SSPs with proactive refill systems (aIRR = 2.08; 95% CI 1.27–3.41; p = 0.004), greater number of distribution days (aIRR = 1.09 per day; 95% CI 1.06–1.11; p < 0.001) and older programs (aIRR = 1.06 per year; 95% CI 1.02–1.11; p = 0.004) were associated with higher levels of naloxone distribution. Also, SSPs with proactive refill systems (aIRR = 2.23; 95% CI 1.38–3.58; p = 0.001); greater number of distribution days (aIRR = 1.04; 95% CI 1.02–1.07; p < 0.001) and older programs (aIRR = 1.11; 95% CI 1.05–1.17; p < 0.001) were associated with a higher number of people receiving naloxone.ConclusionWe identified outer and inner setting factors of SSPs that were associated with greater naloxone distribution. It is critical to ensure SSPs are adequately resourced to build community support for services and develop service delivery models that maximize naloxone distribution to address the nation’s opioid overdose crisis.

Reimagining rural cancer care - the Butaro Cancer Center of Excellence (BCCOE) in Rwanda.

Introduction and Problem Statement: Long travel distance, lack of access to clinical trials and reduced availability of interdisciplinary treatments are some of the structural barriers in providing cancer care in rural areas, even in high-income countries. In low- and middle-income countries (LMICs), such challenges are disproportionately exacerbated. It is estimated that 70% of all cancer-related deaths will occur in LMICs by 2040. Thus, rural cancer care in LMICs calls for urgent innovative interventions aligning with the principles of health equity.Model Solution: Launched in 2012, the Butaro Cancer Center of Excellence (BCCOE) is an example of transformative collaboration and innovation. It harnesses the principle of equity by expanding specialized care to remote and rural populations. It delivers cancer-related diagnostic, chemotherapy, palliative and surgical services with the support of national and regional referral hospitals for advanced cancer surgeries and radiotherapy. Complementary social support, such as meals, transportation and living accommodations for families, further optimize patient outcomes by accommodating patients' psychosocial needs while they receive cancer care.Discussion: By 2020, the BCCOE had treated over 11,116 cancer patients from Rwanda, Burundi and the Democratic Republic of Congo. Furthermore, innovative approaches such as the Zipline delivery system - a drone-based drug re-fill community delivery system - were adopted to tide over during the COVID-19 pandemic. As a growing global community of health leaders, it is imperative to adapt these novel designs and augment healthcare delivery for rural populations.

Development and evaluation of an automated solvent-assisted flavour evaporation (aSAFE)

Artefact-avoiding isolation of the volatiles from foods is a crucial step before analysis of odour-active compounds by gas chromatography (GC). In the past 20 years, solvent extraction followed by solvent-assisted flavour evaporation (SAFE) has become the standard approach, particularly prior to GC–olfactometry. The manual valve of the SAFE equipment, however, leads to suboptimal yields and the risk of a contamination of the volatile isolate with non-volatiles. We thus developed an automated SAFE (aSAFE) approach by replacing the manual valve with an electronically controlled pneumatic valve. The aSAFE provides clearly higher yields than the manual SAFE (mSAFE), notably from extracts high in lipids and for odorants with comparably high boiling points. Additionally, aSAFE substantially reduces the risk of non-volatiles being transferred to the volatile isolate. Full automatisation is possible by combining the aSAFE approach with an automated liquid nitrogen refill system as well as an endpoint recognition and shut-off system.

A VOSviewer-Based Bibliometric Analysis of Prescription Refills.

PurposePrescription refills are long-term prescriptions for chronic patients in stable status, which varies from country to country. A well-established prescription refill system is beneficial for chronic patients’ medication management and facilitates the efficacy of clinical care. Therefore, we carried out a bibliometric analysis to examine the development of this field.SummaryPublications on prescription refills from 1970 to 2021 were collected in the Web of Science Core Collection (WoSCC). Search strategy TS = “prescri* refill*” OR “medi* refill*” OR “repeat prescri*” OR “repeat dispens*” OR TI = refill* was used for search. VOSviewer was applied to visualize the bibliometric analysis. A total of 319 publications were found in WoSCC. Study attention on prescription refills has shown a steady rise but is still low in recent years. The United States was the most productive country, which had the highest total citations, average citations per publication, and the highest H-index, and participated in international collaboration most frequently. The University of California system was the most productive institution. The U.S. Department of Veterans Affairs was the institution with the most citations, most average citation, and highest H-index. Sundell was the most productive author, and Steiner J. F. was the most influential author. “Adherence,” “medication,” and “therapy” were the most prominent keywords.ConclusionPublications on prescription refills have increased rapidly and continue to grow. The United States had the leading position in the area. It is recommended to pay closer attention to the latest hotspots, such as “Opioids,” “Surgery,” “Differentiated care,” and “HIV.”

A multi-item manufacturing system with an outsourcer and random defective items

This study examines a multi-item manufacturing problem with a single machine, an outsourcer, and random defective items. To cope with the increasing multi-product demands from global markets, modern manufacturing firms must make an efficient production plan to satisfy customer’s needs with quality goods and smooth the in-house fabrication schedule and utilization. Outsourcing is an effective option to avoid machine overloads and smooth fabrication schedules. Further, the fabrication of random defective products is inevitable because of unanticipated factors in real manufacturing environments. These products must be identified, separated and discarded to retain the desired quality of the finished lot. To address the above-mentioned concerns, this study develops a mathematical model to represent a hybrid stock refilling system, employs mathematical derivations to find long-run average system expenses, and uses an optimization technique to derive a closed-form common rotation time for this hybrid system. The results of this study show the individual and combined impacts of variations in outsourcing percentages and scrap rates on optimal rotation time and diverse core system parameters (such as machine utilization, specific cost component, etc.) to facilitate planning, controlling, and decision making in such a particular hybrid fabrication system.

Reduced Incidence of Healthcare-associated Infections in a Long-term Care Facility by Converting to Automated Touchless Dispensing and Closed-refill Systems

Background Automated touchless dispensing and closed-refill systems minimize touch points that help prevent cross contamination events and reduce dispenser contamination with clinically significant pathogens in healthcare settings. Additionally, most consumers prefer touchless dispensing when using public restrooms. However, many healthcare settings still utilize manual dispensers for soap and sanitizer. Some even have open, bulk, refillable dispensing systems and manual pumps and dispensers. A finding of a clinical in-use study revealed a significant reduction in the incidence of healthcare associated infections (HAIs) following the conversion to automated touchless soap and sanitizer dispensing systems with premeasured dosage amounts in a long-term care (LTC) care facility. Methods A LTC facility was qualified as a testing site for clinical in-use study of hand hygiene (HH) products’ impact on healthcare workers’ (HCWs) hands. The facility replaced all HH manual dispensing systems and locally purchased hygiene products with automated touchless dispensers, closed-refill systems, and quality formulations. In addition to the biophysical measurements of HCWs hands using bioengineering instrumentation, the baseline incidence of HAIs was recorded prior to the intervention and surveillance continued from 2014 to 2018. HAI rates provided by the testing site were compared to the baseline data collected in 2014 with specific emphasis on the infection outbreak season from October to December in each year. Results Descriptive data analysis of HAI incidence rates revealed significant and sustained reduction in HAI rates from 6.7% in October through December of 2014 to 1.6 % the same period in 2015, 2.8 % in 2016 and 2.4 % in 2017. Conclusions Converting the HH framework from manual dispensing to automated touchless dispensing with closed refill systems during a clinical-in-use study resulted in a sustained reduction of HAI rates over a 3-year period. Increased awareness of HH, touchless hygienic dispensing systems, and HCW improved skin integrity are variables to consider for HAI reduction. Automated touchless dispensing and closed-refill systems minimize touch points that help prevent cross contamination events and reduce dispenser contamination with clinically significant pathogens in healthcare settings. Additionally, most consumers prefer touchless dispensing when using public restrooms. However, many healthcare settings still utilize manual dispensers for soap and sanitizer. Some even have open, bulk, refillable dispensing systems and manual pumps and dispensers. A finding of a clinical in-use study revealed a significant reduction in the incidence of healthcare associated infections (HAIs) following the conversion to automated touchless soap and sanitizer dispensing systems with premeasured dosage amounts in a long-term care (LTC) care facility. A LTC facility was qualified as a testing site for clinical in-use study of hand hygiene (HH) products’ impact on healthcare workers’ (HCWs) hands. The facility replaced all HH manual dispensing systems and locally purchased hygiene products with automated touchless dispensers, closed-refill systems, and quality formulations. In addition to the biophysical measurements of HCWs hands using bioengineering instrumentation, the baseline incidence of HAIs was recorded prior to the intervention and surveillance continued from 2014 to 2018. HAI rates provided by the testing site were compared to the baseline data collected in 2014 with specific emphasis on the infection outbreak season from October to December in each year. Descriptive data analysis of HAI incidence rates revealed significant and sustained reduction in HAI rates from 6.7% in October through December of 2014 to 1.6 % the same period in 2015, 2.8 % in 2016 and 2.4 % in 2017. Converting the HH framework from manual dispensing to automated touchless dispensing with closed refill systems during a clinical-in-use study resulted in a sustained reduction of HAI rates over a 3-year period. Increased awareness of HH, touchless hygienic dispensing systems, and HCW improved skin integrity are variables to consider for HAI reduction.

Intravenous (IV) Monitoring and Refilling S ystem

Intravenous (I.V.) Monitoring and Refilling System is a system for monitoring I.V. therapy and notifying abnormal drip rate and refilling of the I.V. bag. The system has a portable receiver device (for the nurse/nurse station) and a transmitter device (for the patient). The study uses Radio Frequency (RF) medium. RF module was used for transmitting and receiving of the current status data of the monitoring and notifying system. The system has also fiber optic sensors for detecting and counting the drip rate of the I.V. bag. The control panel of the system is placed on the transmitter (patient side). The main objective of the monitoring system is to process an accurate I.V. therapy, prevent the possible backflow of the blood by stopping the I.V. set attached to the system. It makes the I.V. therapy setup fast and easy allowing more time for nurses to perform duties other than monitoring the IV therapy of patients assigned to them. System test results show that transmission delay is not evident in closed area and can transmit accurately without delay up to 70 meters. A 100% detection rates were also recorded for different drip rates and percent IV bag content. Comparing the operating frequency of the I.V. monitoring and refilling system to other medical equipment, the RF module used in the system has an operating frequency that is unique among all the technologies and equipment that may be present in a hospital or clinical setting. The system can also cut down the cost of such medical equipment by 72% if compared to the infusion pump available in the market.

Combined effect of pill refilling and self-medication reminder system on patients’ adherence to tuberculosis treatment during continuation phase in Northwest Ethiopia: a study protocol for randomised controlled trial

IntroductionPatients’ failure to adhere on tuberculosis (TB) treatment leads to drug resistance, relapse and death. Non-adherence to TB treatment is higher during continuation treatment phase. The study aimed to evaluate...

Optimal scheduling and sequencing for large-scale seeding operations

We consider a scheduling and sequencing optimization problem with application to an agricultural seeding operation. The problem is motivated by potential deployment of a recently proposed mobile seed refilling system in large-scale field operations. In this setting, mobile refiller vehicles are used to minimize any interruptions to seeding that result from the need to refill the seed tanks on the planters. A feature of this refilling system is that the two types of vehicles can move together during the seed transfer operation. The optimization task seeks to determine locations where seed transfer should be initiated, as well as an ordering of visits of refiller vehicles to such locations, such that the total downtime is minimized. In this paper, we consider such an optimization task for the case of multiple planters and a single refiller that, in turn, can refill itself at a single, fixed, off-field location. We rely on a stochastic solution strategy for solving this problem by applying the genetic algorithm to a binary integer programming model that represents the decision of whether to initiate refilling or not at a discrete set of possible locations along each planter path. The results are compared with a conventional static refilling scheme (with no mobile refiller), as well as a greedy (but generally suboptimal) algorithm that produces a unique solution to the selection and ordering of rendezvous locations. The computational analysis provides deep and useful insights to this optimization problem.

Challenges of Instituting a Prescription Refill System in Japan

Challenges of Instituting a Prescription Refill System in Japan

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.

Incorporating an expedited rate, rework, and a multi-shipment policy into a multi-item stock refilling system

Facing harsh competition in global marketplaces, management must construct the best possible supply chains to meet client requirements of quality, timely, and diverse products. To accelerate the fabrication rate can help shorten the length of the refilling cycle, and the reworking of repairable defectives can retain the requisite quality standard as well as reduce cost in production. Seeking to build an integrated fabrication-delivery model to help satisfy client timely multiproduct needs with quality goods and minimum cost, this study explores a multi-item stock refilling system incorporating an expedited rate, rework, and multiple shipments plan. An explicit mathematical model is developed to clearly represent various features of the problem. Analytical derivations are used to find the relevant cost function of the system. Applying the Hessian matrix equations to the cost function obtained from our model, the optimal length of the refilling cycle and frequency of delivery can be concurrently determined. This particular model and its analytical results reveal the individual and joint impact of various features on the problem, and can assist operational managers in determining a strategy regarding the expedited rate, controlling requisite product quality levels, and planning the most economic frequency of delivery.

Note: An automatic liquid nitrogen refilling system for small (detector) Dewar vessels.

Many infrared spectroscopy setups are in principle stable enough to run overnight or longer, but the detector's Dewar vessel must be refilled manually with liquid nitrogen (LN2) every couple of hours. Commercial automatic LN2 refilling systems work reliably only for large Dewars. Here, we present a refilling system which can non-invasively be applied to already installed small Dewars. The system reliably refills LN2 once it has dropped below an adjustable level, with quick refilling (<3 min) for a 0.6 l Dewar. Our design protects the setup and the detector from overflowing or running without LN2.

A Digital Language Divide? The Relationship between Internet Medication Refills and Medication Adherence among Limited English Proficient (LEP) Patients.

Use of an Internet portal to refill medicines positively affects medication adherence among English-speakers. No prior studies, however, have specifically examined the relationship between Internet refills and medicationadherence among patients who are limited English proficient (LEP). (1) Examine the relationship between Internet medication refill system use and medication adherence among linguistically diverse patients with chronic conditions and (2) compare this relationship between LEP and English-proficient (EP) patients. We analyzed 2013-2014 cross-sectional data from 509 surveyed adults in the Group Health Cooperative. Surveys were merged with plan enrollment, claims data, and electronic medical records. Medication adherence was calculated by the "Continuous Measure of Medication Gaps" (CMG) method. For Internet refill system use, patients were asked, "Have you used the health systems Internet site to refill any medications in the last 12 months?" LEP status was captured in the electronic medical record by a non-English primary language and a claims record of interpreter use in at least one clinical encounter between 2005 and 2012. We used multivariate linear regression models to examine Internet refill system use and medication adherence and compared the association between LEP and EP patients. Three hundred eighty-four patients (75%) had a calculable CMG: 134 EP and 250 LEP in the adherence analyses. In unadjusted analyses, LEP patients had lower use of the Internet refill system (p < .001) and lower adherence versus the EP group (p < .001). In multivariate analyses, LEP status (β = - 0.022, p = .047) was negatively associated with adherence, while use of the Internet refill system (β = 0.030, p = .002) was positively associated. In stratified models, use of Internet refills was positively associated with adherence, even when examining LEP (β = 0.029, p = .003) and EP patients (β = 0.027, p = .049) separately. These findings suggest that LEP patients may be under-utilizing a beneficial Internet tool. Should our healthcare systems fail to ensure that LEP patients have full and meaningful access to Internet patient portals, we risk worsening healthcare disparities.