July 2021
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Background ePrescription enables to investigate primary non-adherence (PNA) to pharmacotherapy by studying the percentage of prescriptions which have been issued (a prescription record present) but not dispensed in a pharmacy (a dispensation record missing) out of a total number of registered prescriptions. Identification of non-adherence enables to analyze its causes and target them efficiently. Methods This paper investigates PNA rate for prescriptions issued to patients with chronic diseases such as hypertension, diabetes mellitus and hypercholesterolemia (N=108 735), and its dependence on the following variables: geographic location, age, sex, social status, physicians specialty and the level of patient‘s co-payment for medications. The presented dataset comprises a private health insurance company’s prescription data collected over a period of 12 months (January 2018 – December 2018). Results The PNA rate for ePrescriptions issued to patients with the above-mentioned chronic diseases reached up to 4.0%. In general, the PNA rate showed decrease with increasing comorbidity as well as with age. Primary non-adherence rates were lowest for the prescriptions written by general practitioners (3.6%). Among health insurance premium defaulters who pay the full price of prescribed medications, the PNA rate showed decrease with their cost. Significantly higher PNA rate was observed among premium payers (40.4%) compared with premium defaulters (3.5%). Conclusions Interestingly, the very high rate of adherence among patients with chronic diseases exceeds the numbers previously reported in the literature, where adherence rate ≥80% is described as ‘good’ adherence. This could be partially explained by the fact that the present study included only chronic-disease patients undergoing a medical treatment – non-diagnosed patients or patients without a medical treatment were not considered.