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Refill adherence for patients with asthma and COPD: comparison of a pharmacy record database with manually collected repeat prescriptions
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
2007 (English)In: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 16, no 4, 441-448 p.Article in journal (Refereed) Published
Abstract [en]

PurposeTo compare refill adherence data based on two different methods of data capturing, that is, manually collected repeat prescriptions and a pharmacy record database.MethodsThe study comprised a comparison of adherence data from manually collected repeat prescriptions of asthma and chronic obstructive pulmonary disease (COPD) drugs with fixed dosages dispensed in 2002 and the corresponding data from a pharmacy record database. Data were collected in the county of Jämtland in Sweden. Refill adherence was calculated for the different collection methods.ResultsData from 285 manually collected repeat prescriptions for asthma/COPD drugs for 2002 showed that 35% of the prescribings had been satisfactory refilled, while 42% showed an undersupply and 23% an oversupply. The pharmacy record database had 490 prescribings for asthma/COPD drugs registered in 2002, 28% of these had a satisfactory refill adherence, while 43% showed an undersupply, and 29% an oversupply. Based on the database it could be shown that 11% of the individuals had used more than one repeat prescription of the same medicine during 2002. Based on the pharmacy record database for 1999-2002, it was shown that 29% of the prescribings had been satisfactory refilled whereas undersupply increased (53%) and oversupply decreased (18%) as compared to the 1-year data.ConclusionsRefill adherence determined from manually collected repeat prescriptions and from a pharmacy record database did not differ for a 1-year period. Four-year data might give a better overview of patients' refill adherence than 1-year data.

Place, publisher, year, edition, pages
2007. Vol. 16, no 4, 441-448 p.
Keyword [en]
repeat prescriptions, pharmacy record database, refill adherence, asthma, COPD
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-96047DOI: 10.1002/pds.1321PubMedID: 17006959OAI: oai:DiVA.org:uu-96047DiVA: diva2:170484
Available from: 2007-09-03 Created: 2007-09-03 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Refill Adherence to Long-Term Drug Treatment with a Focus on Asthma/COPD Medication
Open this publication in new window or tab >>Refill Adherence to Long-Term Drug Treatment with a Focus on Asthma/COPD Medication
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Most patients are non-adherent with their medication sometimes, i.e. that they do not always use their medicines as prescribed. This might result in both under- and overuse and can lead to therapy failure, resulting in both unnecessary suffering and high costs. Therefore, medication adherence should be as high as possible.

The aims of this thesis were to investigate the refill adherence to long-term drug treatment, especially for patients with asthma and chronic obstructive pulmonary disease (COPD), and to study treatment gaps for patients with undersupply and drug costs for patients with oversupply. Further aims were to compare different methods for assessing refill adherence and analyse whether the same patient has the same refill adherence pattern to two different chronic drug treatments, i.e. diabetes and asthma/COPD.

The thesis shows that satisfactory refill adherence (80-120% of the prescribed dose) was 57% for repeat prescriptions with long-term drug treatment; undersupply was 21% and oversupply 22%. Patients with undersupply were without drugs more than half of the prescribed treatment time and the median oversupply for 90-100 days dispensation interval was 28 days. Patients who were exempt from charges had significantly higher oversupply than non-exempt patients and that leads to unnecessary cost for society. The level of satisfactory refill adherence for repeat prescriptions dispensed for asthma/COPD was on average 30%. The same low level was displayed for the elderly, where undersupply was more common than oversupply.

Assessments of refill adherence during a one-year period gave the same results irrespective of whether the repeat prescriptions were from an individual pharmacy record database or were manually collected at a pharmacy.

Patients with concomitant use of diabetes and asthma/COPD drugs do not have the same dispensation pattern for both drug types.

The introduction of patient profiles as a new approach to complement the calculated refill adherence needs to be further studied in larger and more divergent populations. In the future, the new national pharmacy record database in Sweden has opened up for larger studies and will be valuable when studying patterns of drug utilization.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 75 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Pharmacy, ISSN 1651-6192 ; 60
Keyword
Community pharmacy services, asthma, chronic disease, COPD, diabetes, pharmacy record database, prescription, refill adherence, Samhällsfarmaci
Identifiers
urn:nbn:se:uu:diva-8094 (URN)978-91-554-6931-3 (ISBN)
Public defence
2007-09-21, B7:113a, Uppsala Biomedicinska centrum, Husargatan 3, Uppsala, 09:15
Opponent
Supervisors
Available from: 2007-09-03 Created: 2007-09-03Bibliographically approved

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