Background: Significant challenges to medication continuity often occur when patients transition from inpatient to outpatient care. At discharge, patients may face medication access barriers (MABs), including high costs, prior authorizations, and medication shortages. These barriers can result in adverse events, delayed therapy initiation, suboptimal disease management, and increased hospital readmissions. Consequently, many institutions have adopted transitions of care strategies, such as pharmacy-led medication reconciliation, to address MABs. Pharmacists are uniquely positioned to identify and mitigate MABs prior to hospital discharge; however, standardized workflows for addressing these barriers remain limited. The purpose of this study is to evaluate current MAB processes, with results used to optimize pharmacist workflow in identifying and addressing MABs and potentially support the creation of a new medication access pharmacy position.
Methods: This was a retrospective cohort study that characterized documented MABs at Prisma Health Richland Hospital and Prisma Health Children’s Hospital – Midlands between May 11th, 2025, and December 11th, 2025. MABs involving intravenous medications were excluded. The primary objective was to characterize documented MABs. Secondary objectives included describing pharmacist assignments, resolution of MABs, communication of MABs, discharge pharmacy practices, ambulatory care follow-up, hospital readmission rates, and time spent completing MAB interventions.
