Initiation and Single Dispensing in Cardiovascular and Insulin Medications: Prevalence and Explanatory Factors.
adherence
cardiovascular diseases
insulin
medication initiation
primary care
real-world data
Journal
International journal of environmental research and public health
ISSN: 1660-4601
Titre abrégé: Int J Environ Res Public Health
Pays: Switzerland
ID NLM: 101238455
Informations de publication
Date de publication:
12 05 2020
12 05 2020
Historique:
received:
15
04
2020
revised:
08
05
2020
accepted:
10
05
2020
entrez:
16
5
2020
pubmed:
16
5
2020
medline:
9
10
2020
Statut:
epublish
Résumé
Adherence problems have negative effects on health, but there is little information on the magnitude of non-initiation and single dispensing. The aim of this study was to estimate the prevalence of non-initiation and single dispensation and identify associated predictive factors for the main treatments prescribed in Primary Care (PC) for cardiovascular disease (CVD) and diabetes. Cohort study with real-world data. Patients who received a first prescription (2013-2014) for insulins, platelet aggregation inhibitors, angiotensin-converting enzyme inhibitors (ACEI) or statins in Catalan PC were included. The prevalence of non-initiation and single dispensation was calculated. Factors that explained these behaviours were explored. At three months, between 5.7% (ACEI) and 9.1% (antiplatelets) of patients did not initiate their treatment and between 10.6% (statins) and 18.4% (ACEI) filled a single prescription. Body mass index, previous CVD, place of origin and having a substitute prescriber, among others, influenced the risk of non-initiation and single dispensation. The prevalence of non-initiation and single dispensation of CVD medications and insulin prescribed in PC in is high. Patient and health-system factors, such as place of origin and type of prescriber, should be taken into consideration when prescribing new medications for CVD and diabetes.
Sections du résumé
BACKGROUND
Adherence problems have negative effects on health, but there is little information on the magnitude of non-initiation and single dispensing.
OBJECTIVE
The aim of this study was to estimate the prevalence of non-initiation and single dispensation and identify associated predictive factors for the main treatments prescribed in Primary Care (PC) for cardiovascular disease (CVD) and diabetes.
METHODS
Cohort study with real-world data. Patients who received a first prescription (2013-2014) for insulins, platelet aggregation inhibitors, angiotensin-converting enzyme inhibitors (ACEI) or statins in Catalan PC were included. The prevalence of non-initiation and single dispensation was calculated. Factors that explained these behaviours were explored.
RESULTS
At three months, between 5.7% (ACEI) and 9.1% (antiplatelets) of patients did not initiate their treatment and between 10.6% (statins) and 18.4% (ACEI) filled a single prescription. Body mass index, previous CVD, place of origin and having a substitute prescriber, among others, influenced the risk of non-initiation and single dispensation.
CONCLUSIONS
The prevalence of non-initiation and single dispensation of CVD medications and insulin prescribed in PC in is high. Patient and health-system factors, such as place of origin and type of prescriber, should be taken into consideration when prescribing new medications for CVD and diabetes.
Identifiants
pubmed: 32408626
pii: ijerph17103358
doi: 10.3390/ijerph17103358
pmc: PMC7277594
pii:
doi:
Substances chimiques
Angiotensin-Converting Enzyme Inhibitors
0
Cardiovascular Agents
0
Hypoglycemic Agents
0
Insulin
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Références
Can J Cardiol. 2012 Sep-Oct;28(5):567-73
pubmed: 22658124
Br J Clin Pharmacol. 2012 May;73(5):691-705
pubmed: 22486599
J Gen Intern Med. 2012 Jan;27(1):57-64
pubmed: 21879374
Br J Gen Pract. 2010 Feb;60(571):49-55
pubmed: 20132693
Soc Sci Med. 2005 Jul;61(1):133-55
pubmed: 15847968
J Manag Care Spec Pharm. 2018 Aug;24(8):778-794
pubmed: 30058985
Diabetes Care. 2012 Apr;35(4):774-9
pubmed: 22344609
Value Health. 2015 Jul;18(5):690-9
pubmed: 26297098
Int J Pharm Pract. 2010 Aug;18(4):217-25
pubmed: 20636673
Br J Clin Pharmacol. 2007 Jun;63(6):698-708
pubmed: 17214831
JAMA Intern Med. 2013 Jan 14;173(1):38-43
pubmed: 23403978
PLoS One. 2017 Mar 10;12(3):e0173617
pubmed: 28282465
Ann Intern Med. 2014 Apr 1;160(7):441-50
pubmed: 24687067
Lancet. 2016 Mar 5;387(10022):957-967
pubmed: 26724178
J Manag Care Pharm. 2007 Jul-Aug;13(6):487-96
pubmed: 17672810
Gac Sanit. 2008 May-Jun;22(3):179-87
pubmed: 18579042
Eur Heart J. 2018 Jan 7;39(2):119-177
pubmed: 28886621
Res Social Adm Pharm. 2020 May;16(5):663-672
pubmed: 31402307
Eur J Clin Pharmacol. 2014 Jun;70(6):757-63
pubmed: 24756147
Clin Ther. 2005 Jul;27(7):1064-73
pubmed: 16154485
Value Health. 2000 Nov-Dec;3(6):417-26
pubmed: 16464201
J Manag Care Spec Pharm. 2015 Feb;21(2):124-31
pubmed: 25615001
Med Clin (Barc). 2012 May 19;138(14):617-21
pubmed: 22444996
Health Syst Transit. 2010;12(4):1-295, xix-xx
pubmed: 21224176
Aten Primaria. 2016 Mar;48(3):149-58
pubmed: 26388468
Clin Ther. 2019 Jan;41(1):107-117
pubmed: 30591287
J Am Pharm Assoc (2003). 2017 May - Jun;57(3S):S270-S273.e2
pubmed: 28506380
J Public Health (Oxf). 2019 Mar 1;41(1):e84-e94
pubmed: 29850883
Ann Pharmacother. 2011 Sep;45(9):1053-60
pubmed: 21852598
Eur Heart J. 2013 Oct;34(38):2940-8
pubmed: 23907142
BMC Public Health. 2018 Aug 6;18(1):975
pubmed: 30081871
BMJ Open. 2018 Jan 21;8(1):e016982
pubmed: 29358417
Am J Epidemiol. 1989 Jan;129(1):125-37
pubmed: 2910056
Rev Esp Cardiol (Engl Ed). 2012 Jan;65(1):29-37
pubmed: 22036238
J Am Heart Assoc. 2017 Jul 25;6(7):
pubmed: 28743788
Ann Intern Med. 2018 Jul 3;169(1):30-35
pubmed: 29946690
Br J Gen Pract. 2017 Sep;67(662):e614-e622
pubmed: 28760740
CMAJ. 2014 Sep 2;186(12):E449-56
pubmed: 24958839
Health Educ Res. 2014 Oct;29(5):755-63
pubmed: 24838119
J Ayub Med Coll Abbottabad. 2018 Oct-Dec;30(4):552-557
pubmed: 30632336
Br J Clin Pharmacol. 2017 Jun;83(6):1328-1340
pubmed: 28229476
Patient Educ Couns. 2004 Nov;55(2):301-7
pubmed: 15530768
Int J Clin Pract. 2015 May;69(5):597-603
pubmed: 25648769
J Affect Disord. 2018 Jan 15;226:282-286
pubmed: 29024901
BMJ Qual Saf. 2018 Nov;27(11):878-891
pubmed: 29545326
Diabetes Care. 2010 Apr;33(4):733-5
pubmed: 20086256
Am J Hypertens. 2012 Feb;25(2):195-203
pubmed: 22089108