2041-P: Pharmacist-Led Refill Authorization in Endocrinology: Advancing Patient Safety and Workflow Efficiency

Introduction and Objective: Refill requests account for a significant portion of provider in-basket workload in most practices but especially endocrinology. Our primary objective was to change the workload and workflow efficiency after pharmacy integration into refill management. Some additional objectives were identifying safety concerns like overdue labs, drug-drug interactions, inappropriate dosing, and side effects. Methods: We defined inclusion/exclusion criteria and build pharmacist-managed refill workflow. Our inclusion criteria were adults 18 years or older with active prescriptions managed by University Hospitals Endocrinology providers. Patients were requesting prescription refills for chronic disease management (e.g., diabetes, thyroid disorders, hypertension, hyperlipidemia, obesity, etc.). The exclusion criteria were patients starting new therapies or needing treatment adjustments outside the scope of refill protocols. We pulled baseline data from electronic medical records on refill volume, turnaround time, and safety issues. Then implemented pharmacist-led refill authorization under Collaborative Practice Agreement (CPA) protocols. Results: In 2025, the pharmacy team has completed 3750 refill requests for the Endocrinology department providers. That is 3750 prescriptions that never had to reach the providers in basket. Our preliminary findings suggest that pharmacist involvement in refill workflow reduces provider administrative workload. The addition of pharmacy-led refills enhances patient safety through proactive monitoring due to protocols. Conclusion: A CPA can expand the work of the pharmacist not only to include dispensing medications but also managing medication therapy. This can integrate automatic tools to streamline refill triage. The CPA can also reduce the frequent communication between the provider and the pharmacist and based on protocols; this leads to quicker adjustments in medications and more efficient team-based care. The expansion of a CPA scope could be replicated in other specialties in additional outpatient clinics. Disclosure J. Fetzner: None. B. Hatipoglu: Consultant; Ended; Lilly. Other - Site PI for a study; Ended; Diasome. N. Bellini: Speaker's Bureau; Current; Abbott Diabetes, Dexcom, Inc. Consultant; Current; Eli Lilly and Company. Speaker's Bureau; Current; MannKind Corporation, Sanofi. Consultant; Current; Medtronic. Consultant; Ended; Becton, Dickinson and Company.