Effect of community pharmacist-provided patient education of partial fill availability for acute opioid prescriptions.

BACKGROUND: More than 191 million opioid prescriptions were filled in the United States during 2017, and studies have shown that patients often have leftover medication. OBJECTIVES: To (1) measure the percentage filled as partial quantities and the percentage subsequently filled to completion; (2) determine which medications are filled as partial, completion, and full fills; and (3) identify patient reasons and demographics for partial, completion, and full fills. PRACTICE DESCRIPTION: Two pharmacies of a national community pharmacy chain in Richmond, VA. PRACTICE INNOVATION: Virginia law allows prescriptions to be filled in partial quantities as long as the total quantity does not exceed the written quantity and the remaining portions are filled within 30 days of the written date. Pharmacists developed an intervention to educate patients about the option to fill opioid prescriptions as a partial quantity. EVALUATION METHODS: Retrospective analysis of drug utilization reports to identify the impact of the pharmacist intervention for acute, nonmaintenance opioid prescriptions filled as partial, completion, or full fill during a 5-month period. Patient demographics and reasons for choosing a partial or full fill were collected using surveys completed at prescription pickup. RESULTS: A total of 25.6% of included prescriptions were partially filled, and of these, only 31.9% were filled to completion. Hydrocodone-acetaminophen was the most common prescription, 35.8% full, 28.3% partial, and 36.4% completion fills. Patients' motivation was driven by the pharmacist's suggestion (48.5%) for partial fill and desire to have the medication if needed (36.6%) for full fill. CONCLUSION: Pharmacist offer of partial filling of acute opioid prescriptions may lead patients to partially fill prescriptions, and patients cited the pharmacist suggestion as a motivator.

A classroom-based patient case activity as a potential formative indicator of pre-advanced pharmacy practice experience readiness.

BACKGROUND AND PURPOSE: Pharmacy programs must assess student readiness for advanced pharmacy practice experiences (APPEs). This study evaluated: (1) if a relationship exists between student performance on a classroom-based patient case activity (Rx Review) and (2) performance on direct patient care and perceptions of the transferability of Rx Reviews to the APPE setting. EDUCATIONAL ACTIVITY AND SETTING: Rx Reviews are timed, independent, prospective reviews of a patient's medical record intended to simulate pre-rounding activities common in acute and ambulatory care settings. Students complete 12 Rx Reviews across a skills laboratory course sequence. Rx Review scores were compared to performance on acute care and ambulatory care APPEs for students in the Class of 2019 using descriptive statistics for student scores and bivariate logistic regression for the association between Rx Review scores and performance outcomes on patient care APPEs. Student perceptions of the Rx Reviews were assessed through a survey. Descriptive statistics and qualitative responses were used to analyze responses to the multiple-choice survey questions and open-ended question, respectively. FINDINGS: One hundred twenty-two students participated in the study. A relationship was found between students' Rx Review scores and performance in certain direct patient care APPEs, with students performing in the bottom 50% on Rx Reviews being more likely to perform poorly on those APPEs. Over 93% of students identified Rx Reviews as at least somewhat helpful in preparing them for APPEs. SUMMARY: This study indicated that a classroom-based patient case activity could be used as a formative measure of APPE readiness.