Journal of Health and Medical Sciences
ISSN 2622-7258
Published: 30 September 2023
Standardization of the Medication Review Process in Primary Care: A Quality Improvement Project
Sara Murphy, Megan Wesling, Vicki Cannon, Subhada Kambhampaty
University of North Texas Health Science Center
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10.31014/aior.1994.06.03.282
Pages: 101-107
Keywords: Medication Review, Re-prescribing, Electronic Health Records, Medication Protocol, Drug Related Problem, Polypharmacy, Medication Reconciliation, Attrition
Abstract
Introduction: Medication review process (MRP), especially pertaining to prescription refills, poses significant challenges in primary care. If MRPs are not conducted with care, then patients come under the risk of drug-related problems (DRPs), including receiving incorrect medication or dosage, therapeutic duplications, refilling a previously discontinued medication, nonadherence, and overdosing. Aim and Research Gap: Standardized approaches to medication review are currently limited in practice. Also, reviewing and reconciling patient medications is time-consuming and contributes to practitioner burnout. Therefore, this quality improvement project aimed to incorporate simple medication review protocols into patient care, a standardized rooming experience, and updated medication refill procedures to lessen the burden of refill requests on a primary healthcare facility, and to improve patient and healthcare staff safety and satisfaction in the USA. Methods: An evidence-based method, lean process improvement approach was used. An interdisciplinary team was created to map out the medication refill process. Convenience sampling was used to collect data, including phone calls, from November 1, 2021, to November 2, 2022, from the practice’s Nextgen EHR system. The names of highly prescribed medications and the frequency of these medications as being re-prescribed were quantified and the interdisciplinary team met to discuss opportunities for improvement. Results: This quality improvement project analyzed the challenges in a single United States primary care facility’s medication refill process and suggested simple improvements. The facility received significantly fewer refill phone calls after streamlining communication to patients to bring their medication prescription bottles to appointments, standardizing rooming experiences, updating clinic protocols and workflows, and training staff to complete medication verification (p < 0.001). Discussion and Conclusion: The findings from this quality improvement project support the necessity of standardized protocols in a medication review and refill processes in primary care settings with its positive impact impacts.
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