Evaluating a Pharmacist-Led Medication Refill Management Service


A study presented at ASHP Midyear 2023 found that primary care physicians said a refill management service helped reduce burnout and improved the quality of patient care.

A medication refill management service led by pharmacists in an ambulatory care setting helped reduce the overall workload of primary care physicians, according to research presented at the American Society of Health-System Pharmacists 2023 Midyear Clinical Meeting and Exhibition, held from December 3 to 7 in Anaheim, California.1

Primary care physicians in ambulatory care settings are primarily concerned with direct patient care, which leaves them little time to deal with medication refill requests. Because pharmacists are medication experts, they can help physicians by assessing refill requests and communicating any recommendations to optimize management.

Investigators from the community hospital Ascension Saint Mary in Chicago, Illinois conducted a retrospective study to evaluate the impact of a medication refill management service pilot. Data was gathered from 2 primary care sites that consisted of 9 providers from May 2022 to February 2023.

A refill management service team made up of 2 ambulatory care pharmacists and 3 technicians maintained medication refills for up to a six month supply. Requests sent to providers to address included medications indicated for an acute treatment, medications not previously prescribed by the primary care physician, and medications not active on the current medication list within the electronic medical record.

The primary study outcome was to describe and quantify pharmacist interventions. Secondary outcomes included cost savings of each intervention type, percentage of pharmacist addressed refill requests, number of clinical recommendations, and provider satisfaction scores.

Investigators found that all of the primary care physicians said the refill service reduced burnout and improved the quality of patient care. Only 75% said that the recommendations helped close care gaps, but all of them said they would recommend the refill service to their colleagues. Over the 12-month study period, there were 5922 interventions made. The most common was the need for a follow-up appointment, followed by need for laboratory monitoring, and avoidance of inappropriate therapy.

A total of 46349 refill requests were addressed by the providers and pharmacists, with 22731 requests addressed directly by the refill management service. Additionally, the total cost of savings from the interventions amounted to $1,053,024.

“Implementation of a pharmacist led medication refill management service reduced the amount of refill requests providers needed to address,” the authors concluded. “The diligent efforts of the ambulatory care team led to a significant number of interventions and recommendations to optimize therapies and reduce medication errors. The reduced workload on primary care physicians and staff was met with positive provider satisfaction survey results.”

1. Huttner J, Allison M, Foglio J, et al. Impact of an Ambulatory Care Pharmacist-Led Medication Refill Management Service in Primary Care. Presented at: American Society of Health-System Pharmacists Midyear Clinical Meeting & Exhibition; December 3-7, 2023; Anaheim, CA. Poster 4-007.
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