Effect of prescription refill on quality of care among patients with type 2 diabetes: An exploratory study

Aim: Prescription refill might be effective in saving health expenditures, but whether a refilled prescription that reduces physician consultation affects quality of diabetes care is unknown. This study sought to examine the effect of prescription refill on the outcome quality of diabetes care. Methods: A quasi-experiment design with repeated HbA1c measures for the pretest and posttest periods for a total of 2 years was used. HbA1c functions as an outcome quality indicator. Prescription refill was measured dichotomously and also in times. Retrospective data of 1005 patients with type 2 diabetes were analyzed mainly by repeated measure General Linear Modeling at the multivariate level with difference-in-difference (DID) statistics. Results: Patients using prescription refills (n=779) experienced a significant decrease in HbA1c (from 8.4% to 7.8%, P<. 0.001), compared with those without refill (n=226, from 8.5% to 8.3%, P=0.171), with 0.3% of DID (P=0.043). Compared with non-refill peers, a greater percentage of patients refilling their prescriptions met the American Diabetes Association standards goal of (<7%/53. mmol/mol, P=0.037). Certain patients and physician characteristics were associated with the use of refills. Conclusions: Clinically appropriate use of prescription refill would not result in a deterioration in glycemic control. On this basis, continuous refills may further benefit diabetic patients in treatment outcome and future cost. More attention is needed on the quality-effectiveness of prescription refill.