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Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute
Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute

Journal of Health and Medical Sciences

ISSN 2622-7258

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open access

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

journal of social and political sciences
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Pages: 101-107

Keywords: Medication Review, Re-prescribing, Electronic Health Records, Medication Protocol, Drug Related Problem, Polypharmacy, Medication Reconciliation, Attrition


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.


  1. Alghadeer, S., Al-Thunayan, S. F., Alghamdi, B. M., Bintaleb, D. A., & Alnaim, L. (2021). Evaluation and pharmacists perspective of repeat prescribing process in refill clinics. Journal of the Saudi Pharmaceutical Society.

  2. Assab, M. A., Alhamad, H., Almazari, I., Azzam, B., & Assab, H. A. (2022). Barriers to Medication Review Process Implementation—Cross-Sectional Study among Community Pharmacists in Jordan. Healthcare, 10(4), 651.

  3. Bhakta, K., Lee, K. C., Luke, T., & Bouw, J. W. (2022). Impact of a pharmacist-run refill and prior authorization program on physician workload. Journal of the American Pharmacists Association, 62(3), 727-733.e1.

  4. Bloomfield, H. E., Greer, N., Linsky, A., Bolduc, J., Naidl, T., Vardeny, O., MacDonald, R., McKenzie, L., & Wilt, T. J. (2020). Deprescribing for Community-Dwelling Older Adults: a Systematic Review and Meta-analysis. Journal of General Internal Medicine, 35(11), 3323–3332.

  5. Bourne, R. S., Jennings, J. K., Panagioti, M., Hodkinson, A., Sutton, A., & Ashcroft, D. M. (2022). Medication-related interventions to improve medication safety and patient outcomes on transition from adult intensive care settings: a systematic review and meta-analysis. BMJ Quality & Safety, 31(8), 609–622.

  6. Dautzenberg, L., Bretagne, L., Koek, H. L., Tsokani, S., Zevgiti, S., Rodondi, N., Scholten, R. J. P. M., Rutjes, A. W. S., Di Nisio, M., Raijmann, R. C. M. A., Emmelot-Vonk, M. H., Jennings, E., Dalleur, O., Mavridis, D., & Knol, W. (2021). Medication review interventions to reduce hospital readmissions in older people. Journal of the American Geriatrics Society, 69(6), 1646–1658.

  7. Doshi, J. A., Lim, R. K. S., Li, P., Young, P., Lawnicki, V., State, J. J., Troxel, A. B., & Volpp, K. G. (2016). A synchronized prescription refill program improved medication adherence. Health Affairs, 35(8), 1504–1512.

  8. Dunham, D., & Christopher, C. (2022). A prescription refill intervention to improve patient and physician satisfaction. International Archives of Public Health and Community Medicine, 6(1).

  9. Isfahani, H. M., Tourani, S., & Seyedin, H. (2019). Features and results of conducted studies using a lean Management Approach in Emergency Department in Hospital: A Systematic review. Bulletin of Emergency and Trauma, 7(1), 9–20.

  10. Morales-Contreras, M. F., Chana-Valero, P., Suárez‐Barraza, M. F., Díaz, A. S., & García-García, E. (2020). Applying lean in process innovation in healthcare: The case of hip fracture. International Journal of Environmental Research and Public Health, 17(15), 5273.

  11. Rantsi, M., Hyttinen, V., Jyrkkä, J., Vartiainen, A., & Kankaanpää, E. (2022). Process evaluation of implementation strategies to reduce potentially inappropriate medication prescribing in older population: A scoping review. Research in Social & Administrative Pharmacy, 18(3), 2367–2391.

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