A stethoscope laying on top of a laptop; blue network diagram of various healthcare icons

Upwards of 50% of patients do not take their medications as prescribed or are non-adherent. Medication non-adherence and its associated negative health outcomes, such as hospitalizations and death, result in over $100 billion of avoidable healthcare costs in the United States annually. Medication non-adherence is a complex problem enabled by numerous patient, medication, provider, and system-wide factors. System factors may include healthcare costs, availability of medical appointments, or access to a community pharmacy, such as CVS or Walgreens.

Prescribers can address non-adherence and promote correct medication use by developing trusting patient-prescriber relationships and engaging patients and their caregivers in discussions about their medication therapies.

Current methods for prescribers to identify medication non-adherence are suboptimal. Patient self-reported adherence may be inaccurate due to misremembering or intentionally overreporting to please their provider. Patients’ medication insurance plans (also known as pharmacy benefit managers [PBMs]) may send providers letters or faxes when patients’ prescriptions are not picked up, but this information is often delayed months after the missed fills. PBM claims and adherence calculations that are based on dates the pharmacy fills the prescription (i.e., fill dates) are also limited because they assume once patients have the medicine in their possession, they will always take it correctly.

Health information technology (IT) has made great strides in facilitating communication between prescribers and pharmacies, including electronic prescriptions. Novel health IT functionalities incorporate prescription fill dates and adherence data into the electronic health record (EHR). Two of these functionalities are RxFill and Electronic Pharmacy Claims Data. RxFill integrates prescription fill dates from the patients’ community pharmacy into their clinic EHR record. Electronic Pharmacy Claims Data (EPCD) incorporates prescription fill dates from the patient’s PBM into the EHR.

Although medication adherence measures may be limited individually, combining prescription fill dates with patient self-reported adherence at the time of an appointment may enhance prescribers’ ability to make decisions regarding medications and clinical care. Prescribers may use prescription fill dates to quickly assess for non-adherence and engage patients in collaborative conversations. Health IT that incorporates prescription fill dates and adherence into the EHR must be useful, easy to use, and fit into the prescriber’s daily work.

Health IT aimed at incorporating prescription fill dates and medication adherence data into the EHR, such as RxFill and EPCD, have great potential to improve patient safety and promote quality outcomes, but only if the prescribers have access and use them regularly.

Therefore, our research aims to examine healthcare professionals’ acceptance and current use of RxFill and EPCD, as well as provide best practice recommendations for other health systems, clinics, and providers that will maximize RxFill and EPCD use and adoption.

This project was funded by the NCPDP Foundation. This video shares a brief overview of RxFill and some preliminary findings.

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