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Primary nonadherence to drugs prescribed by general practitioners: A Dutch database study
Mirjam Hempenius1, Simone Rijken1, Rolf H H Groenwold2
1Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
British Journal of Clinical Pharmacology
|July 27, 2022
Summary
Over 11% of new prescriptions were not filled, impacting patient health and data accuracy. Factors like comorbidities and drug reimbursement status influenced this primary nonadherence.
Area of Science:
- Pharmaceutical Sciences
- Public Health
- Epidemiology
Background:
- Primary nonadherence (PNA), the failure to fill an initial prescription, compromises patient outcomes.
- PNA can lead to inaccurate drug exposure data in prescription databases.
- Understanding PNA is crucial for improving medication adherence and research validity.
Purpose of the Study:
- To quantify the prevalence of primary nonadherence in Dutch primary care.
- To identify patient and prescription characteristics associated with PNA.
Main Methods:
- Utilized the Nivel Primary Care Database linked with pharmacy dispensing data (2012).
- Defined PNA as not dispensing a new prescription within 30 days.
- Employed mixed-effects logistic regression to analyze associated factors.
Main Results:
- 11.5% of 181,939 new drug prescriptions showed primary nonadherence.
- PNA rates varied by drug class, from 5.5% for thyroid hormones to 12.8% for proton pump inhibitors.
- Comorbidities (OR 1.46) and non-reimbursed status (OR 2.78) significantly increased PNA risk.
Conclusions:
- A substantial proportion of new prescriptions are not filled in primary care.
- PNA can lead to overestimation of drug exposure in prescription databases.
- Identifying factors associated with PNA can inform interventions to improve adherence.
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