Initial medication non-adherence: prevalence and predictive factors in a cohort of 1.6 million primary care patients.
Por:
Aznar I, Fernández A, Gil MM, Fajó-Pascual M, Moreno-Peral P, Peñarrubia-Teresa MT, Serrano-Blanco A, Sánchez-Niubó A, March-Pujol MA, Jové AM and Rubio-Valera M
Publicada:
1 jun 2017
Ahead of Print:
24 feb 2017
Resumen:
AIMS: Adherence to medicines is vital in treating diseases. Initial medication non-adherence (IMNA) - defined as not obtaining a medication the first time it is prescribed - has been poorly explored. Previous studies show IMNA rates between 6 and 28% in primary care (PC). The aims of this study were to determine prevalence and predictive factors of IMNA in the most prescribed and expensive pharmacotherapeutic groups in the Catalan health system. METHODS: This is a retrospective, register-based cohort study which linked the Catalan PC System (Spain) prescription and invoicing databases. Medication was considered non-initiated when it was not collected from the pharmacy by the end of the month following the one in which it was prescribed. IMNA prevalence was calculated using July 2013-June 2014 prescription data. Predictive factors related to patients, general practitioners and PC centres were identified through multilevel logistic regression analyses. Missing data were attributed using simple imputation. RESULTS: Some 1.6 million patients with 2.9 million prescriptions were included in the study sample. Total IMNA prevalence was 17.6% of prescriptions. The highest IMNA rate was observed in anilides (22.6%) and the lowest in angiotensin-converting-enzyme (ACE) inhibitors (7.4%). Predictors of IMNA are younger age, American nationality, having a pain-related or mental disorder and being treated by a substitute/resident general practitioner in a resident-training centre. CONCLUSIONS: The rate of IMNA is high when all medications are taken into account. Attempts to strengthen trust in resident general practitioners and improve motivation to initiate a needed medication in the general young and older immigrant population should be addressed in Catalan PC.
Filiaciones:
Aznar I:
Teaching, Research & Innovation Unit, Fundació Sant Joan de Déu, Esplugues de Llobregat, Spain
Primary Care Prevention and Health Promotion Research Network (redIAPP), Barcelona, Spain
School of Pharmacy, University of Barcelona, Barcelona, Spain
Fernández A:
Mental Health Policy Unit, The Brain and Mind Research Institute
and Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
Gil MM:
Teaching, Research & Innovation Unit, Fundació Sant Joan de Déu, Esplugues de Llobregat, Spain
Fajó-Pascual M:
Faculty of Health and Sport Sciences, University of Zaragoza, Huesca, Spain
Moreno-Peral P:
Primary Care Prevention and Health Promotion Research Network (redIAPP), Barcelona, Spain
Unidad de Investigación del Distrito Sanitario de Atención Primaria Málaga-Guadalhorce, Málaga, Spain
Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
Peñarrubia-Teresa MT:
Insitut Catalá de la Salut (ICS), Catalonia, Spain
Serrano-Blanco A:
Primary Care Prevention and Health Promotion Research Network (redIAPP), Barcelona, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Sánchez-Niubó A:
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
March-Pujol MA:
School of Pharmacy, University of Barcelona, Barcelona, Spain
Jové AM:
Insitut Catalá de la Salut (ICS), Catalonia, Spain
Rubio-Valera M:
Teaching, Research & Innovation Unit, Fundació Sant Joan de Déu, Esplugues de Llobregat, Spain
Primary Care Prevention and Health Promotion Research Network (redIAPP), Barcelona, Spain
School of Pharmacy, University of Barcelona, Barcelona, Spain
Open Access
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