Primary non-adherence in Portugal: findings and implications

Area of Science:

• Pharmacoeconomics and Health Outcomes Research
• Public Health and Epidemiology
• Patient Adherence Studies

Background:

• Portugal's economic crisis impacts healthcare, potentially affecting medication access and adherence for chronic patients.
• Understanding adherence is crucial for managing chronic conditions amidst financial challenges.
• Community pharmacies play a key role in patient medication management.

Purpose of the Study:

• To assess medication adherence in Portuguese patients with chronic conditions.
• To identify primary and secondary nonadherence rates and their contributing factors.
• To provide a snapshot of adherence during a period of economic constraint in 2012.

Main Methods:

• A cross-sectional pilot study conducted in community pharmacies across Portugal.
• Patient recruitment via community pharmacies for a questionnaire-based study.
• Evaluation of prescribed versus purchased drugs and reasons for discrepancies, including primary and secondary nonadherence measures.

Main Results:

• Primary nonadherence was reported by 22.8% of patients, with "spare medicines at home" and financial problems as primary reasons.
• Financial constraints were linked to lower income (<475 euros/month) and specific medication classes.
• Secondary nonadherence, assessed by the 7-Medication Adherence and Satisfaction Scale (7-MMAS), affected over 50% of patients, with unintentional nonadherence being more prevalent.

Conclusions:

• Over one-fifth of chronic medication users exhibited primary nonadherence, and more than half showed secondary nonadherence.
• Spare medicines and financial difficulties were the most frequently cited reasons for nonadherence.
• Adherence challenges in chronic patients are significant and influenced by economic factors and medication management practices.