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Unfilled prescriptions in pediatric primary care
Rachael T Zweigoron1, Helen J Binns, Robert R Tanz
1Department of Pediatrics, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA. rach_zweig@yahoo.com
Insights
Over 20% of pediatric prescriptions go unfilled, impacting medication adherence. Factors like clinic site and electronic prescribing influence filling rates, suggesting system-level interventions are needed.
Area of Science:
- Pediatric Primary Care
- Health Services Research
- Medication Adherence
Background:
- Prescription filling is the critical first step in medication adherence.
- This process has not been adequately studied in pediatric primary care settings.
- Understanding prescription filling rates is essential for improving pediatric health outcomes.
Purpose of the Study:
- To determine the rate of unfilled prescriptions in pediatric primary care.
- To identify clinical and demographic factors associated with prescription filling.
- To inform the development of interventions aimed at improving medication adherence.
Main Methods:
- Retrospective observational study using Illinois Medicaid claims data.
- Compared electronic medical record prescription data with insurance claims for 4833 pediatric patients.
- Analyzed 16953 prescriptions over 26 months, assessing filling within 1 and 60 days using logistic regression.
Main Results:
- 78% of all pediatric prescriptions were filled; 69% of filled prescriptions were dispensed within 1 day.
- African American, Hispanic, and male patients showed higher prescription filling rates.
- Antibiotic prescriptions, electronic prescribing, and visits at specific clinic sites were associated with higher filling rates.
Conclusions:
- More than 20% of prescriptions in pediatric primary care remain unfilled.
- Clinical site, visit type, and electronic prescribing are significant system-level factors affecting prescription filling.
- Future interventions to enhance medication adherence must consider these identified factors.
Background And Objectives:
Filling a prescription is the important first step in medication adherence, but has not been studied in pediatric primary care. The objective of this study was to use claims data to determine the rate of unfilled prescriptions in pediatric primary care and examine factors associated with prescription filling.
Methods:
This retrospective observational study of pediatric primary care patients compares prescription data from an electronic medical record with insurance claims data. Illinois Medicaid provided claims data for 4833 patients who received 16953 prescriptions during visits at 2 primary care sites over 26 months. Prescriptions were compared with claims to determine filling within 1 day and 60 days. Clinical and demographic variables significant in univariate analysis were included in logistic regression models.
Results:
Patients were 51% male; most (84%) spoke English and were African American (38.7%) or Hispanic (39.1%). Seventy-eight percent of all prescriptions were filled. Among filled prescriptions, 69% were filled within 1 day. African American, Hispanic, and male patients were significantly more likely to have filled prescriptions. Younger age was associated with filling within 1 day but not with filling within 60 days. Prescriptions for antibiotics, from one of the clinic sites, from sick/follow-up visits, and electronic prescriptions were significantly more likely to be filled.
Conclusions:
More than 20% of prescriptions in a pediatric primary care setting were never filled. The significant associations with clinical site, visit type, and electronic prescribing suggest system-level factors that affect prescription filling. Development of interventions to increase adherence should account for the factors that affect primary adherence.
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