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Physician influence on medication adherence, evidence from a population-based cohort
Shenzhen Yao1, Lisa M Lix2, Gary Teare3
1College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Plos One
|December 1, 2022
Summary
General practitioner influence on statin adherence is minimal. Even high-performing physicians struggle with suboptimal patient adherence, indicating limited prescriber impact on medication compliance.
Area of Science:
- Cardiovascular Health
- Pharmacoeconomics
- Health Services Research
Background:
- Population-level impact of physician prescribers on medication adherence is not well understood.
- Statin therapy is crucial for cardiovascular disease prevention, making adherence a key health outcome.
Purpose of the Study:
- To quantify the influence of general practitioner (GP) prescribers on optimal statin medication adherence.
- To determine the proportion of adherence variance attributable to physician prescribers versus patient factors.
Main Methods:
- Retrospective cohort study utilizing health administrative data from Saskatchewan, Canada (2012-2017).
- Analysis included 1,562 GPs and 51,874 new statin users.
- Multivariable logistic regression and mixed-effects models assessed prescriber and patient factors affecting adherence (proportion of days covered ≥ 80%).
Main Results:
- Median optimal statin adherence across GPs was 52.4%.
- Higher adherence GPs had older, sicker patients.
- Only 6.4% of adherence variance was attributable to GPs after accounting for patient factors; most of this was unexplained variance.
Conclusions:
- General practitioner prescribers have a very limited impact on population-level statin adherence.
- Suboptimal adherence remains a significant challenge even for physicians with higher-performing patient groups.
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