Assessing pharmacy student-driven refill capture and adherence improvement in a health system pharmacy setting.

Purpose: In order to improve medication adherence, combat DIR fees and improve refill capture in a pharmacy health system with limited financial resources we implemented a program using students to manage refill requests. UIHealth pharmacies use Enterprise software which is equipped with a Contact Manager for organizing refills requests and replies, but due to the temporary staffing nature of our resident prescribers many refill requests are either not generated automatically within Enterprise or are simply ignored. By offering elective credit to students our goal was to allow an opportunity for professional development while providing better and timelier patient care.

Method: Our Contact Manger refill pilot program consisted of three phases. Phase 1 began during the summer of 2018 and involved the centralized facilitation on an informal basis of refill management with no record keeping or data analysis. Phase 2 involved the expansion of the program to include three pharmacy students from the University of Illinois College of Pharmacy. The students were trained on our pharmacy and hospital software and then given access to their respective pharmacies. Weekly logs were maintained to quantify progress in the program. Phase 3 involved the further expansion of the program to four students, this time without the training requirement since student externs were recruited, and the same records were kept for further evaluation of the program.

Results: Pharmacy students worked in weekly two hour increments and an overall measurement was taken of events worked on in the contact manager. Data was recorded using a spreadsheet; attempts were identified as either an initial attempt, the deletion of a duplicate entry or an event that was already completed, and a received reply (either refill approval, denial or dose modification). A weekly evaluation was made to determine students were improving on a regular basis. Upon conclusion of the pilot students were performing over 100 contact manager events every week which is outreach that was taking days, sometimes weeks to occur using our existing staffing model. Although adherence data is still being analyzed feedback from pharmacy staff as well as the students who participated was positive, and raw data clearly shows an improvement in refill capture as well as the elimination of contact manager events which have already been responded to and prohibit the efficient sorting of the queue.

Conclusion: Health systems pharmacies with limited staffing resources and time that have access to an associated college of pharmacy can greatly benefit by incorporating students into the workflow. This also offers an opportunity for the students to get valuable work experience. In our health systems setting by offering elective credit we were able to successfully engage students in helping us to manage our refill capture and improve patient adherence.