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Avni Badami, Kathryn Kosteva, Marissa Fiorello, Babak Eliassi-Rad, Manishi Desai; Barriers to medication compliance in an urban underserved population. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3725.
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Despite the availability of multiple minimally invasive surgical options and laser treatments, topical medications remain a mainstay of glaucoma treatment. In absence of proper medication compliance, patients may need to undergo invasive surgical procedures which are not without risk. The first step to medication compliance is medication availability and we often find on follow up visits that patients are not obtaining medications for various reasons. This study was performed to assess whether medication refills prescribed are reaching the pharmacy, and more importantly, if patients are obtaining these medications. We aim to detect common workflow problems applicable to any major eye practice in order to improve medication compliance.
Prescription refills are requested through telephone messages, which are then transcribed onto a paper refill request form and then electronically prescribed by a physician. With institutional review board approval, for a period of one week, all prescription refill requests were recorded and pharmacies were contacted the week and month following prescription refill requests to determine if the requested medications were received. The data were retrospectively reviewed.
In the study period, 66 subjects requested 84 medications. Of the 84 medications requested, 47 (55.9%) medications were picked up by the subject and 25 (29.8%) of requested medications were filled by the pharmacy but never picked up. 6 (12.8%) of the requested medications were not available due pending prior authorizations, 4 (4.8%) of the requested medications were denied by insurance, and 4 (2.4%) of requested medications were previously discontinued by the physician and inappropriately requested.
A majority of glaucoma medication refills requested are received within a month of the request; however a large number of requested medications are filled by the pharmacy but never picked up. This study provides insight to the first barrier to medication compliance: receiving the medication. Transportation issues and medication cost are potential issues which may account for prescriptions that are not received. Further studies are needed to implement improvement measures to increase the number of medications received by patients and increase compliance.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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