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EXCEED Project 4
 
Improving Care for High Risk Minority Patients with Chronic Illnesses by Using Pharmacist Consultations to Follow Up on Missed Prescription Refills
 
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This study will use the capabilities of a commercially available pharmacy computer system to identify chronically ill patients who are at risk for not refilling their prescriptions for medications that have proven value in controlling exacerbation of their illnesses.

Pharmacies that serve a large number of black patients will be chosen to participate in this intervention. Patients will either receive a telephone call from a pharmacist or a mailed reminder to fill their prescription. This intervention will be evaluated using data from the pharmacy computer system.

The purpose of this project is to demonstrate that commercial pharmacy computer systems can be used to identify patients at risk for poor adherence to life and cost saving medications. The patients identified through this method will receive a call from a pharmacist to remind them that it is time for their medication to be refilled, and to discuss any problems. This approach of selecting high-risk patients should prove more cost effective than approaches where all patients receive counseling. We will compare responses to mailed reminders and to no reminders.

As a first step, using an electronic data collection system at two pharmacies, non-adherent patients will be identified. Patients who have missed at least one prescription refill by one week during the one to two month will be selected. They will be assigned randomly to two treatment groups and a control group. The control group will receive no special treatment; one experimental group will get a telephone reminder/counseling; the other will receive a reminder in the mail.

After six months compliance will be re-evaluated using the electronic data collection system. Various types of medications for certain chronic diseases will be targeted (see attached medication list). The conditions include high blood pressure, elevated cholesterol, heart failure, diabetes, and depression.

If the intervention proves successful in the two pharmacies, it will be tested in community pharmacies in areas of the state with a large percentage of black residents.

Poster.
Service Center Medical University of South carolina         Department of Biostatistics, Bioinformatics, and Epidemiology
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