09 Apr Why Do Some Patients Fail To Get Their Prescriptions Filled?
MedicalResearch.com Interview with:
Robyn Tamblyn BScN Msc PhD
James McGill Chair
Departments of Medicine and Epidemiology and Biostatistics
McGill University and Scientific Director
Institute of Health Services and Policy Research
Canadian Institutes of Health Research
MedicalResearch.com: What are the main findings of the study?
Dr. Tamblyn: Higher drug costs are associated with a higher probability of primary non-adherence, whereas better follow-up by the prescribing physician, and a policy to provide medication at no cost for the very poor increase the likelihood of adherence
MedicalResearch.com: Were any of the findings unexpected?
Dr. Tamblyn: This is the first opportunity to evaluate whether free medication for the poor increased adherence. It was surprising to see that this simple policy reversed the usual trend to see poorer adherence in the low income groups.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Tamblyn: When there is a failure to respond to prescribed treatment such as poor control of blood pressure or glycemic control in diabetes, a clinician needs to consider the possibility that the the person did not fill the original prescription.
As high drug costs increase the risk of non-adherence, even among insured patients who pay a percentage of the cost, clinicians need to both know and consider the cost of possible therapies in making treatment decisions
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Tamblyn: Two issues need to be addressed.
First what is the consequence of primary non-adherence? If primary non-adherence results in avoidable complications then a new approach to drug policy may be needed to cover the cost of drugs for patients with disease modifiable conditions.
Second, what are the attitudes, knowledge and beliefs of patients who fill and do not fill prescriptions and what interventions would be appropriate in addressing gaps in these areas?
Robyn Tamblyn, Tewodros Eguale, Allen Huang, Nancy Winslade, Pamela Doran; The Incidence and Determinants of Primary Nonadherence With Prescribed Medication in Primary CareA Cohort StudyPrimary Nonadherence With Prescribed Medication in Primary Care. Annals of Internal Medicine. 2014 Apr;160(7):441-450.