Patient experience with medication prescriptions from a pain management clinic. 

Julissa Mireles BS, Ahsan Omer BS, Shibili Sunny FNP, Olga Fleckenstein BS, Mary Lou Warren DNP, Billy K Huh MD PhD, Keyuri Popat MD

Background: Delivering high quality patient experiences is a vital part of healthcare. An after-hours call service is currently available to increase accessibility for patient questions and concerns, consistently utilized after business hours and on weekends for urgent issues. Reasons for these calls are categorized, and pain related calls were noted to be the most common. This quality improvement study focused on identifying common reasons behind pain related calls related to medication refills within a cancer pain management clinic. The aim is to develop actionable and preventive solutions to reduce medication refill calls, a surrogate measure of the patients’ experience with the prescription process in the pain management clinic.

Methods: This retrospective study received approval by the institutional Quality Improvement Assessment Board (QIAB). After-hours calls from September 2023-February 2024 were reviewed using nurse triage notes from the patient charts in the electronic medical record. These data included after-hours call type, reason for visit/call, dispositions, patient center, service level, and category of call. Medication refill related calls were then further evaluated to determine common reasons for the calls. Descriptive statistics were used for analysis.

Results: Between September 1, 2023, and February 28, 2024, there were 7,475 after-hours phone calls, with 873 (11.7%) related to medication refills. The pain management clinic had the highest number of refills calls at 100 (11.5%). Calls were categorized into eight groups based on patient chart notes:

• out-of-stock issues (21);

• communication issues (20);

• no prescription sent/pharmacy did not receive it (18);

• changes in medical condition (11);

• routine refills with no interventions (10);

• need for patient education (8);

• incomplete information (pharmacy, dosage, instructions) (6);

• medication noncompliance (6).

• hydrocodone/acetaminophen (5);

• hydromorphone (5);

• oxycodone (4);

• extended-release morphine (2);

• methadone (2);

• miscellaneous (2);

• fentanyl (1)