Medication non-adherence is a problem of critical importance, affecting approximately 50% of all persons taking at least one regularly scheduled prescription medication and costing the United States more than $100 billion annually. Traditional data sources for identifying and resolving medication non-adherence in community pharmacies include prescription fill histories. However, medication possession does not necessarily mean patients are taking their medications as prescribed. Patient-reported outcomes (PROs), measuring adherence challenges pertaining to both remembering and intention to take medication, offer a rich data source for pharmacists and prescribers to use to resolve medication non-adherence. PatientToc™ is a PROs collection software developed to facilitate collection of PROs data from low-literacy and non-English speaking patients in Los Angeles.


This study will evaluate the spread and scale of PatientToc™ from primary care to community pharmacies for the collection and use of PROs data pertaining to medication adherence.


The following implementation and evaluation steps will be conducted: 1) a pre-implementation developmental formative evaluation to determine community pharmacy workflow and current practices for identifying and resolving medication non-adherence, potential barriers and facilitators to PatientToc™ implementation, and to create a draft implementation toolkit, 2) two plan-do-study-act cycles to refine an implementation toolkit for spreading and scaling implementation of PatientToc™ in community pharmacies, and 3) a comprehensive, theory-driven evaluation of the quality of care, implementation, and patient health outcomes of spreading and scaling PatientToc™ to community pharmacies.

Expected impact

This research will inform long-term collection and use of PROs data pertaining to medication adherence in community pharmacies.


This is the author-accepted manuscript of:

Margie E. Snyder, Betty Chewning, David Kreling, Susan M. Perkins, Lyndee M. Knox, Omolola A. Adeoye-Olatunde, Heather A. Jaynes, Jon C. Schommer, Matthew M. Murawski, Nisaratana Sangasubana, Lisa A. Hillman, Geoffrey M. Curran, An evaluation of the spread and scale of PatientToc™ from primary care to community pharmacy practice for the collection of patient-reported outcomes: A study protocol, Research in Social and Administrative Pharmacy, Volume 17, Issue 2, 2021, Pages 466-474.

Copyright Elsevier, it's made available here CC-BY-NC-ND, and the version of record is available at DOI: 10.1016/j.sapharm.2020.03.019.


Community pharmacy, patient-reported outcomes, health information technology

Date of this Version