Refilling prescriptions and physician consent.

Area of Science:

• Pharmacy Practice
• Health Services Research
• Physician Behavior

Background:

• Physician prescribing behavior is well-documented.
• Physician prescription refill authorization behavior remains understudied.
• Understanding refill authorization is crucial for patient care continuity.

Purpose of the Study:

• To investigate how physicians authorize prescription refills via telephone.
• To assess differences in refill authorization for controlled versus noncontrolled substances.
• To examine if physicians verify patient records before authorizing refills.

Main Methods:

• Systematic random sampling of 30 general practitioners and internists.
• A simulated pharmacy call requesting refill authorization for a fictitious patient.
• Use of both controlled and noncontrolled legend drugs in simulated requests.
• Calls conducted during late afternoon or evening hours.

Main Results:

• 48.3% of physicians authorized refills.
• Controlled substances received authorization in 29% of cases, noncontrolled in 66%.
• Only 27.6% of physicians checked patient records.

Conclusions:

• Physician authorization for prescription refills is inconsistent.
• Controlled substances are less likely to be authorized for refill.
• Lack of record verification raises potential patient safety concerns.