As our regular Word on Health readers will know, I’ve had more than my fair share of trips to the pharmacy recently. Painkillers, antibiotics, anti-inflammatories…the list goes on. It’s not that I like taking tablets, I needed them. Having taken time out of my busy life to see a doctor and get a prescription it would never occur to me to leave it languishing in the bottom of my purse. However, according to a new study almost 1 in every 4 American’s does just that.
The study, published in the November issue of the American Journal of Medicine, evaluated more than 423,000 e-prescriptions written in 2008 for more than 280,000 patients. It was conducted by researchers at Harvard University, Brigham and Women’s Hospital, and CVS Caremark, who matched e-prescriptions with resulting claim data or those who did not claim prescriptions within 6 months.
What they found was that 24% of patients given a new prescription did not fill it. This percentage is higher than that seen in earlier studies.
“While some recent research has used e-prescribing data to evaluate primary non-adherence, we were able to study a nationwide sample of patients. Our finding that 24% of patients are not filling initial prescriptions reflects slightly higher primary non-adherence than seen in earlier studies,” said Michael Fischer, MD, MS, with Brigham and Women’s and Harvard Medical School, and lead author of the study.
Most prior research about medication adherence could not review prescriptions that were never filled by patients. However, the advent of electronic prescribing has provided an opportunity to track initial prescriptions that may have been previously undetected and gives healthcare providers a broader look at patients who never fill their prescriptions.
Researchers said the factors that are predictive of primary non-adherence include:
- the out-of-pocket cost of medications
- socioeconomic factors
- the integration of doctors’ health information systems
- the types of medications.
Prescriptions that are sent directly to mail-order systems and pharmacies are more likely to be filled than e-prescriptions that doctors print out and give to patients, according to the study. The researchers found that medications for hypertension and diabetes resulted in primary non-adherence rates in excess of 25%, while prescriptions for antibiotics and medication for infants were almost always filled.