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Pharmacy and Pharmaceutical Sciences


PDJ Clark, PharmD, PGY1 Pharmacy Practice Resident
Adam Saulles, PharmD, CSP, BCACP; Tara Berkson, PharmD, BCACP

Providence Health and Services, Portland, Oregon

Evaluation of a two-way, HIPAA-compliant text-messaging platform in a health system specialty pharmacy

Specialty medications, including those used to treat Multiple Sclerosis (MS), represent a growing proportion of prescription drug expenditures in the United States. MS is a chronic, progressive condition that requires maintenance therapy with disease-modifying medications. Many patients with MS rely on specialty pharmacies to obtain, dispense, and perform the necessary monitoring for these complex medication regimens. A study performed in 2017 by Munsell et al, demonstrated that only ~50% of patients with MS are adherent to prescribed regimens when initiating disease-modifying therapy. Routine pharmacy outreach could potentially help improve medication adherence in a population at high risk of disease progression secondary to non-adherence. Prior to July 2019, this health system specialty pharmacy only contacted MS patients via phone call to perform refill coordination and pharmacist follow-up. This strategy has been effective, but is not without flaws. Oftentimes, patients prefer not to receive phone calls or are unavailable during pharmacy business hours. This can lead to repeat outreach phone calls from caregivers and gaps in therapy. In July 2019, a HIPAA-compliant messaging platform was implemented. With this program, patients can respond to refill inquiries at their convenience and provide typed responses to medication-related safety, adherence, and efficacy follow-up questions sent by specialty pharmacists. This project seeks to identify whether implementation of the aforementioned messaging platform has had a quantifiable benefit on patient outreach and workflow outcomes within a health system specialty pharmacy setting. This single center, retrospective cohort analysis evaluated adult patients with a diagnosis of MS and at least 2 dispenses of disease-modifying medications. Data was collected via the electronic health record and the implemented text messaging application. The primary outcome is time between pharmacy technician outreach and medication refill. Secondary outcomes include medication adherence reported as medication possession ratio (MPR), the proportion of patients enrolled in the specialty pharmacy’s patient management program, patient satisfaction, and pharmacy phone call volume. Between group differences were described using simple descriptive statistics and T-tests, where applicable. A total of 335 patient had fills prior to and post-implementation of the text messaging platform, and 313 had multiple fills in each category, allowing for calculation of MPR. Response time (HH:MM ± 95% Confidence interval) was significantly decreased with utilization of text-message refill reminders (32:03 ± 7:09 vs 68:34 ± 11:37; p




Graduate Medical Education

Conference / Event Name

Academic Achievement Day, 2020


Providence St. Vincent, PGY-1 Pharmacy Residency Program

Evaluation of a two-way, HIPAA-compliant text-messaging platform in a health system specialty pharmacy