Impact of prescription charges on people living in poverty: A qualitative study

Norris, Pauline; Tordoff, June; McIntosh, Brendon; Laxman, K.; Chang, Shih Yen; Karu, Leanne Te

doi:10.1016/j.sapharm.2015.11.001

Cited by 28 publications

(36 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Primary healthcare accessibility is influenced by ethnicity and socioeconomic status in New Zealand. 43,44 Reduced income may also affect dietary choices, particularly for low nutritional, low-cost food options, which may trigger high blood glucose levels. 44 Non-adherence by patients aged 31-60 years is concerning, as these patients are of 'actively working' age.…”

mentioning

confidence: 99%

“…43,44 Reduced income may also affect dietary choices, particularly for low nutritional, low-cost food options, which may trigger high blood glucose levels. 44 Non-adherence by patients aged 31-60 years is concerning, as these patients are of 'actively working' age. Poor glycaemic control will affect their working ability and productivity and may lead to hospitalisation and additional healthcare costs.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Using the Pharmaceutical Collection Database to identify patient adherence to oral hypoglycaemic medicines

2019

View full text Add to dashboard Cite

INTRODUCTIONPoor adherence to oral hypoglycaemic medicines is a key contributor to therapy failure and sub-optimal glycaemic control among people with type 2 diabetes. It is unclear how commonly non-adherence to oral hypoglycaemics occurs in the general population. This information is essential to design and implement local adherence strategies. AIMThis study aimed to determine levels of sub-optimal adherence and identify patient groups who may need additional adherence support. METHODSThe dispensing data of 340,283 patients from one District Health Board was obtained from the Pharmaceutical Collection Database for the period 2008–15. Of these, 12,405 patients received oral hypoglycaemic therapy during the study period. The proportion of days covered (PDC) was calculated for patients with complete data and a PDC value of ≥80% was used to indicate sufficient adherence. Patient demographics (gender, ethnicity, age, socioeconomic status) and therapy type (mono- or combination) were described. RESULTSOverall, 54.5% of the patients were found to have a PDC of <80% and so were considered non-adherent. Non-adherence was significantly higher in patients receiving combination oral hypoglycaemic therapy than monotherapy; in male patients; in New Zealand Māori patients; and in patients with higher socioeconomic deprivation. DISCUSSIONIn the study region, non-adherence to oral hypoglycaemic medicines was significant and widespread. Identification of such patients is important so that strategies to enhance adherence can be implemented. Prescribers need to be encouraged to optimise monotherapy before the addition of another oral hypoglycaemic, and adherence support services should be offered not only to older patients.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Using the Pharmaceutical Collection Database to identify patient adherence to oral hypoglycaemic medicines

2019

View full text Add to dashboard Cite

show abstract

“…Indeed, it is the personal stories of what it is like to exist without a living wage-their 'audacity' in demanding a doubling of US federal minimum wages-that produces meaningful change. The stories of individuals and communities living below a living wage can be found in Frank McCourt's Angela's Ashes, but there is also a horn o' plenty within journals sitting at the periphery of 'medicine' [242][243][244][245]. The jargonistic term, semi-structured interview, belies the profound stories collated under its technique-narratives of distress in the ecological theatre [246,247].…”

Section: Redefining the Narrativementioning

confidence: 99%

Narrative Medicine Meets Planetary Health: Mindsets Matter in the Anthropocene

Prescott

Logan²

2019

Challenges

View full text Add to dashboard Cite

The emerging concept of planetary health—defined as the interdependent vitality of all natural and anthropogenic ecosystems (social, political, and otherwise)—emphasizes that the health of human civilization is intricately connected to the health of natural systems within the Earth’s biosphere. In the clinical setting, narrative medicine underscores the importance of absorbing, reflecting upon, and responding to the narratives—the stories—conveyed by patients. Education and interventions using the tenets of narrative medicine have demonstrated value to both patient and provider. Given the grand interconnected challenges of our time—compounded by misinformation and quasi-scientific narratives propagated by the ideology of neoliberalism—we argue that the principles and practice of narrative medicine can be applied on a larger scale, one with planetary health in mind. The role of beliefs, expectations, and agency—mindsets—in the link between narrative and planetary health are emphasized. We use a story of our own to demonstrate that the biological buffering capacity in response to a fast-food meal does not sit on a level socioeconomic playing field. Patient, community, and global health narratives are melding with powerful narratives set by commercial entities. The success of planetary health as a new concept will be strengthened by attention to the ways in which storytelling can influence positive change. No less important is an understanding of the ways in which stories contribute to what ails person, place, and planet.

show abstract

“…Thus prescription charges are an important aspect of the interface between consumers and health systems, and experiences of being unable to pay can significantly affect people's interactions with and perceptions of the health system 7 . Prescription charge regimes vary widely in different countries 15,16 .…”

Section: Introductionmentioning

confidence: 99%