Impact of initial medication non-adherence on use of healthcare services and sick leave
Por:
Aznar-Lou, I, Fernandez, A, Gil-Girbau, M, Sabes-Figuera, R, Fajo-Pascual, M, Penarrubia-Maria, MT, Serrano-Blanco, A, Moreno-Peral, P, Sanchez-Niubo, A, March-Pujol, M, Rubio-Valera, M
Publicada:
1 sep 2017
Resumen:
Background
Initial medication non-adherence is highly prevalent in primary care but no previous studies have evaluated its impact on the use of healthcare services and/or days on sick leave.
Aim
To estimate the impact of initial medication non-adherence on the use of healthcare services, days of sick leave, and costs overall and in specific medication groups.
Design and setting
A 3-year longitudinal register-based study of all primary care patients (a cohort of 1.7 million) who were prescribed a new medication in Catalonia (Spain) in 2012.
Method
Thirteen of the most prescribed and/or costly medication subgroups were considered. All medication and medication subgroups (chronic, analgesics, and penicillin) were analysed. The number of healthcare services used and days on sick leave were considered. Multilevel multivariate linear regression was used. Three levels were included: patient, GP, and primary care centre.
Results
Initially adherent patients made more use of medicines and some healthcare services than non-adherent and partially adherent patients. They had lower productivity losses, producing a net economic return, especially when drugs for acute diseases (such as penicillins) were considered. Initial medication non-adherence resulted in a higher economic burden to the system in the short term.
Conclusion
Initial medication non-adherence seems to have a short-term impact on productivity losses and costs. The clinical consequences and long-term economic consequences of initial medication non-adherence need to be assessed. Interventions to promote initial medication adherence in primary care may reduce costs and improve health outcomes.
Filiaciones:
Aznar-Lou, I:
Esplugues Llobregat, Res Inst St Joan Deu, Barcelona, Spain
Ctr Invest Biomed Red Epidemiola & Salud CIBERESP, Madrid, Spain
Fernandez, A:
CIBERESP, Madrid, Spain
Publ Hlth Agcy Barcelona, Community Hlth Serv, Barcelona, Spain
Gil-Girbau, M:
Esplugues Llobregat, Res Inst St Joan Deu, Teaching Res & Innovat Unit, Barcelona, Spain
Primary Care Prevent & Hlth Promot Res Network re, Barcelona, Spain
Sabes-Figuera, R:
CIBERESP, Madrid, Spain
Univ Pompeu Fabra, Fac Econ & Business Sci, Barcelona, Spain
Fajo-Pascual, M:
Univ Zaragoza, Fac Hlth & Sport Sci, Huesca, Spain
Penarrubia-Maria, MT:
CIBERESP, Madrid, Spain
Catalan Hlth Inst, Barcelona, Spain
Serrano-Blanco, A:
CIBERESP, Madrid, Spain
Univ Barcelona, Parc Sanitari St Joan Deu, Barcelona, Spain
Moreno-Peral, P:
RedIAPP, Barcelona, Spain
Sanchez-Niubo, A:
Univ Barcelona, Parc Sanitari St Joan Deu, Barcelona, Spain
March-Pujol, M:
CIBERESP, Madrid, Spain
Univ Barcelona, Sch Pharm, Barcelona, Spain
Rubio-Valera, M:
Esplugues Llobregat, Res Inst St Joan Deu, Barcelona, Spain
Ctr Invest Biomed Red Epidemiola & Salud CIBERESP, Madrid, Spain
Green Published, Bronze
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