Repeat prescriptions: refill adherence in relation to patient and prescriber characteristics, reimbursement level and type of medication

Andersson, Kristin; Melander, Arne; Svensson, Carin; Lind, Owe; Nilsson, J. Lars G.

doi:10.1093/eurpub/cki053

Cited by 61 publications

(66 citation statements)

References 12 publications

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“…Moreover, because adherence to prescribed drug treatment is low (Andersson et al, 2005) and irregular administration of these drugs is common we choose a liberal limit of 12 months, and there were no significant differences when compared to a 6 month cut-off limit. Circumstances which could imply a medical intention of drug intake in the absence of a recent dispense (i.e.…”

Section: Methodological Considerationsmentioning

confidence: 99%

Non-prescribed use of psychoactive prescription drugs among drug-impaired drivers in Sweden

Tjäderborn

Jönsson

Sandström

et al. 2016

Drug and Alcohol Dependence

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Aims: To determine the prevalence of non-prescribed drug use among subjects suspected of drug-impaired driving with a confirmed intake of a psychoactive prescription drug, and to identify associated factors. Methods:Subjects investigated for drug-impaired driving in Sweden during 2006-2009 with a confirmed intake of diazepam, flunitrazepam, tramadol, zolpidem or zopiclone were identified using the Swedish Forensic Toxicology Database. Information on dispensed prescription drugs was retrieved from the Swedish Prescribed Drug Register. Non-prescribed use was defined as a confirmed use of a psychoactive prescription drug intake confirmed by toxicological analysis in a subject by whom it was not dispensed in the 12 months preceding the sampling. Prevalence proportions were calculated for each drug and logistic regression was used to identify associated factors. Results: In total, 2225 subjects were included. The median age (range) was 34 (15-80) years and 1864 (83.8%) subjects were male. Non-prescribed use was found in 1513 subjects (58.7%); for flunitrazepam 103 (76.3%), diazepam 1098 (74.1%), tramadol 192 (40.3%), zopiclone 60 (29.7%), and zolpidem 60 (21.2%) subjects, respectively. Younger age and multiple-substance use were associated with nonprescribed use, whereas ongoing treatment with other psychoactive drugs was negatively associated with nonprescribed use. Conclusions: Non-prescribed use of psychoactive prescription drugs was common in subjects suspected of drug-impaired driving and was more frequent for benzodiazepines and tramadol compared to zolpidem and zopiclone. The young and multi-substance users were more likely, whereas subjects with ongoing prescribed treatment with other psychoactive drugs were less likely, to use non-prescribed drugs.

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Section: Methodological Considerationsmentioning

confidence: 99%

Non-prescribed use of psychoactive prescription drugs among drug-impaired drivers in Sweden

Tjäderborn

Jönsson

Sandström

et al. 2016

Drug and Alcohol Dependence

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“…24 These differences in adherence are often attributed to the quality of the patient-provider interactions; [25][26][27] the salient nontherapeutic features of the drugs prescribed, including the complexity of regimens; 28,29 and the occurrence of unpleasant sideeffects or drug interactions. [30][31][32][33] In short, filling a prescription and taking the medication as prescribed is a complex health behavior determined by the patient's perceptions of drug costs and benefits and mediated by various provider and health system attributes. 34 Much of the literature on medication adherence assumes a rational decision-making process where patients weigh the perceived therapeutic benefits of each medication against the cost of filling the prescription and restrict use of high-cost, lowbenefit medications.…”

mentioning

confidence: 99%

Unfilled Prescriptions of Medicare Beneficiaries: Prevalence, Reasons, and Types of Medicines Prescribed

Kennedy¹,

Tuleu²,

Mackay³

2008

JMCP

137

108

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“…They may for example unintentionally overuse the same medication (168,169), which increases the risk to experience ADRs. Previous studies have found that oversupply of medications was found in up to 53% of patients taking antidiabetics (152,(170)(171)(172)(173), up to 52% with antihypertensive medications (152,170,174,175), and up to 35% with lipid lowering medications (152,170).…”

Section: Non-adherence To Long-term Medicationsmentioning

confidence: 97%

“…For example, non-adherence has been found to be higher for long-term than short term therapies (145), for preventive than curative therapies, and for asymptomatic conditions, such as hypertension (145,146 Refill adherence is one of the most used methods to measure adherence, and has been correlated with other measures of adherence (151). The act of refilling prescribed medications and the frequency of medication refills reflect different aspects of a patient's adherence behaviour, and can be divided into adequate refill adherence, undersupply and oversupply (152). Refill adherence is only considered as a proxy measure of adherence if patients obtain their medications within a closed pharmacy system, such as in countries with universal medication coverage (147).…”

Section: Non-adherence To Long-term Medicationsmentioning

confidence: 99%

Inappropriate prescribing, non-adherence to long-term medications and related morbidities : Pharmacoepidemiological aspects

Hedna

2015

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Aim:The aim of this thesis is to estimate and analyse the burden of potentially inappropriate prescriptions (PIPs) in the elderly and non-adherence to long-term medications among adults across care settings, and to investigate how IUM is associated to DRMs. Methods:A meta-analysis summarised the previous evidence on the percentage of adverse drug reactions (ADRs) associated to IUM across healthcare settings (Study I). From a cohort in the general population, using medical records and register data, the prevalence of PIPs in the elderly and its association with ADRs were estimated retrospectively (Study II). From the same cohort, the factors associated with refill non-adherence to antihypertensive therapy, considering the use of multiple medications, and the association between non-adherence and sub-therapeutic effects (STEs) were investigated (Study III). A survey assessed the refill behaviour to antihypertensive, lipid lowering and oral antidiabetic medications (undersupply, adequate supply and oversupply), and its association with perceived ADRs and STEs (Study IV).Results: IUM was the cause 52% and 45% of ADRs occurring in adult outpatients and inpatients respectively. Across healthcare settings, 46% of the elderly refilled PIPs over a 6-month period;PIPs were considered the cause of 30% of all ADRs; and the elderly who were prescribed PIPs had increased odds to experience ADRs (OR 2.47, 95% CI 1.65-3.69). In total, 35% was nonadherent to the full multidrug therapy and 13% was non-adherent to any medication (complete vi non-adherence). Sociodemographic factors (working age and lower income) were associated with non-adherence to any medication, while clinical factors (use of specialised care, use of multiple medications, and being a new user) with non-adherence to the full multidrug therapy. STEs were associated with non-adherence to any medication a month prior to a healthcare visit (OR 3.27, 95% CI 1.27-8.49), but not with long-term measures of non-adherence. Among survey respondents, 22% of the medications were oversupplied and 12% were undersupplied. Inadequate refill behaviour was not associated with reporting ADRs or STEs (p<0.05). Conclusions:A large proportion of ADRs occurring in hospital is caused by IUM, but more knowledge is needed in other settings. PIPs are common in the elderly general population and associated with ADRs. Therefore decreasing PIPs could contribute towards ADR prevention.Considering the use of multiple medications may help to better understand the factors associated with non-adherence to a multidrug therapy for tailoring the interventions to patient needs.Monitoring the adherence prior to a healthcare visit may facilitate interpreting STEs. Yet, the absence of an association between long-term measures of refill non-adherence with clinical and perceived DRMs suggest the need to enhance the knowledge of this association in clinical practice.In summary, this thesis shows a significant potential for improvements of medication use and outcomes.Key words: Drug-related morbidity, medica...

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Repeat prescriptions: refill adherence in relation to patient and prescriber characteristics, reimbursement level and type of medication

Cited by 61 publications

References 12 publications

Non-prescribed use of psychoactive prescription drugs among drug-impaired drivers in Sweden

Non-prescribed use of psychoactive prescription drugs among drug-impaired drivers in Sweden

Unfilled Prescriptions of Medicare Beneficiaries: Prevalence, Reasons, and Types of Medicines Prescribed

Inappropriate prescribing, non-adherence to long-term medications and related morbidities : Pharmacoepidemiological aspects

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