Medication and health-related outcomes by prescription lengths: A systematic review
- 1Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.
Abstract
Background
Prescription length policies (such as 30, 60, or 90 days) influence medication adherence, healthcare access, costs, and patient safety. However, their overall impact remains unclear because of heterogeneous evidence.Objectives
This systematic review evaluated the effects of prescription length on clinical, economic, and healthcare system outcomes and identified methodological considerations for future research and policy.Methods
PubMed, Scopus, and ScienceDirect were searched for studies published from 2000 to July 1, 2026. Studies comparing different prescription lengths were included, while those unavailable in full text were excluded. Methodological quality was assessed using design-specific critical appraisal tools. Due to substantial heterogeneity in study designs, populations, prescription durations, and outcome measures, findings were synthesized narratively.Results
Twenty-three studies were included. Longer prescription durations were generally associated with improved medication adherence and increased medication waste. Evidence for economic, clinical and healthcare utilization outcomes was more limited and heterogeneous. Among studies of chronic disease management, longer prescription durations were generally associated with lower out-of-pocket costs, transportation cost and patient time cost, and reduced healthcare encounters, although findings for total economic outcomes varied according to the analytical perspective adopted. For acute conditions with opioid use, shorter prescription durations were associated with reduced adverse outcomes, including overdose risk and persistent opioid use. Methodological heterogeneity in study design, outcome definitions, and analytical perspectives contributed to differences in findings across studies.Conclusion
Longer prescription lengths were consistently associated with improved medication adherence but also increased medication waste. Evidence for clinical, economic, and healthcare system outcomes remains limited and heterogeneous and should be interpreted according to medication type and clinical context. Thus, a single prescription duration is unlikely to be appropriate across all settings. Healthcare providers and policymakers should consider medication type, patient needs, treatment stability, and healthcare system context when determining prescription duration. Further well-designed studies using transparent and comparable outcome definitions are needed to strengthen the evidence base for prescription-length decision-making.
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BibTeX
@article{thin2026medication,
title = {{Medication and health-related outcomes by prescription lengths: A systematic review}},
author = {Su Myat Thin and Parnnaphat Luksameesate and Chanthawat Patikorn and Suthira Taychakhoonavudh},
journal = {Exploratory research in clinical and social pharmacy},
year = {2026},
month = oct,
doi = {10.1016/j.rcsop.2026.100862},
url = {https://europepmc.org/article/PMC/PMC13717161},
note = {CC BY},
}
RIS
TY - JOUR
TI - Medication and health-related outcomes by prescription lengths: A systematic review
AU - Su Myat Thin
AU - Parnnaphat Luksameesate
AU - Chanthawat Patikorn
AU - Suthira Taychakhoonavudh
PY - 2026
DA - 2026/10/14
JO - Exploratory research in clinical and social pharmacy
DO - 10.1016/j.rcsop.2026.100862
UR - https://europepmc.org/article/PMC/PMC13717161
AB - Background Prescription length policies (such as 30, 60, or 90 days) influence medication adherence, healthcare access, costs, and patient safety. However, their overall impact remains unclear because of heterogeneous evidence.Objectives This systematic review evaluated the effects of prescription length on clinical, economic, and healthcare system outcomes and identified methodological considerations for future research and policy.Methods PubMed, Scopus, and ScienceDirect were searched for studies published from 2000 to July 1, 2026. Studies comparing different prescription lengths were included, while those unavailable in full text were excluded. Methodological quality was assessed using design-specific critical appraisal tools. Due to substantial heterogeneity in study designs, populations, prescription durations, and outcome measures, findings were synthesized narratively.Results Twenty-three studies were included. Longer prescription durations were generally associated with improved medication adherence and increased medication waste. Evidence for economic, clinical and healthcare utilization outcomes was more limited and heterogeneous. Among studies of chronic disease management, longer prescription durations were generally associated with lower out-of-pocket costs, transportation cost and patient time cost, and reduced healthcare encounters, although findings for total economic outcomes varied according to the analytical perspective adopted. For acute conditions with opioid use, shorter prescription durations were associated with reduced adverse outcomes, including overdose risk and persistent opioid use. Methodological heterogeneity in study design, outcome definitions, and analytical perspectives contributed to differences in findings across studies.Conclusion Longer prescription lengths were consistently associated with improved medication adherence but also increased medication waste. Evidence for clinical, economic, and healthcare system outcomes remains limited and heterogeneous and should be interpreted according to medication type and clinical context. Thus, a single prescription duration is unlikely to be appropriate across all settings. Healthcare providers and policymakers should consider medication type, patient needs, treatment stability, and healthcare system context when determining prescription duration. Further well-designed studies using transparent and comparable outcome definitions are needed to strengthen the evidence base for prescription-length decision-making.
SN - 2667-2766
ER -