Pharmacists Educate Patients on Partial Fill Option for Acute Opioid Prescriptions

After a pharmacist’s offer, patients may increasingly opt to partially fill rather than fully fill acute opioid prescriptions, new research indicates.

“Decreased dispensing in the form of partial fills is an option for avoiding unnecessary medication that does not burden patients with arranging proper disposal,” wrote Wylie BP Crane, PharmD, clinical pharmacist, Kroger Health, and coauthors.

To understand the impact of pharmacist-led education on patient decision making, researchers gathered drug utilization reports and patient survey data for 2 pharmacies in Richmond, Virginia. Under Virginia law, patients can get partially filled prescriptions “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.”

Just over one quarter (25.6%) of acute opioid prescriptions were partially filled after pharmacist counseling. Only 31.9% of partially filled prescriptions were then filled to completion, findings showed.

Among those who opted for partial filling, 48.5% of patients indicated their motivation was spurred by the pharmacist’s suggestion. On the other hand, 36.6% of patients who fully filled their prescriptions wanted to have the medication if needed.

Included in the analysis were prescriptions for codeine, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, and tramadol, as well as medications that incorporate these substances with acetaminophen or naloxone. The most common prescription was hydrocodone combined with acetaminophen.

A direct cause and effect link between the intervention and patients’ decision to partially fill could not be established, but pharmacist-led education “provided relevant information about the ability to partially fill their prescription which they might not have known prior to the education," researchers wrote.

“Previous to this study, 0 prescriptions were filled as partial fills without pharmacist counseling at either of the data collection pharmacies. As a result of patients choosing to partially fill their prescription, 24.1% less medication that met inclusion criteria was dispensed during the data collection period,” authors said.

Researchers recommended all patients filling acute opioid prescriptions be educated on the partial fill option, but prioritized groups could include those filling a prescription after surgery and those with insurance.

Reference:
Crane WBP, Page A, Nadpara PA, Goode J. Effect of community pharmacist-provided patient education of partial fill availability for acute opioid prescriptions. J Am Pharm Assoc. Published online April 14, 2022. doi:10.1016/j.japh.2022.04.007