RESUMO
INTRODUCTION: Primary nonadherence to medication occurs when a patient does not fill a prescription and often leads to suboptimal patient outcomes, lost productivity, and increased net costs. Pilot introduction of electronic prescriptions (eprescriptions) in Poland took place in 2018, enabling nationwide assessment of primary nonadherence. OBJECTIVES: To determine the prevalence and drivers of primary nonadherence in Poland. METHODS: This retrospective analysis included data from all eprescriptions issued in Poland in 2018. Primary nonadherence was defined as not filling a prescription within 1 month from the date of issuing. RESULTS: Out of all 119 880 eprescriptions issued in Poland in 2018, 94 913 were filled, thus the primary nonadherence rate reached 20.8%. Although no differences in primary nonadherence were observed between sexes, age was found to have a significant effect, with older groups showing lower rates of primary nonadherence. In addition, slightly lower rates of primary nonadherence (17.0%) were found for eprescriptions issued for selected drugs of key importance (n = 47 492). Multivariable analysis performed within this subset showed that those aged ≥75 years had the lowest odds for nonadherence (odds ratio, 0.55; 95% CI, 0.48-0.64). Differences in primary nonadherence rates were observed across therapeutic areas (lowest value in antibiotics, 14.3%), drug classes (lowest value in sulfonylureas, 13.2%), and individual drugs. Primary nonadherence rates were lower for drugs covered by the "Leki 75+" program, which makes them free of charge for those aged 75 years or older. CONCLUSIONS: A high percentage of prescriptions issued in Poland are never filled. Eprescriptions allow the identification and analysis of drivers of this phenomenon. Our findings may help designing national health and medicine policies.
Assuntos
Prescrição Eletrônica , Adesão à Medicação/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Estudos Retrospectivos , Fatores Sexuais , Adulto JovemRESUMO
BACKGROUND: In allergic conditions such as allergic rhinitis and urticaria, orally administered H1-antihistamines belong to first-line therapy and therefore, are widely prescribed. Due to the frequent, and often chronic, course of allergic diseases, adherence is of great importance. In 2018 a novel, nationwide e-prescription system was piloted in Poland, which allowed to analyze primary non-adherence to orally administered H1 antihistamines. OBJECTIVES: To assess the primary non-adherence to orally administered H1-antihistamines in Poland, defined as not redeeming the drug issued on a particular e-prescription within its validity period. METHODS: The study was based on all e-prescriptions issued in Poland in 2018, issued for 119.880 drugs. The analysis included nine major orally administered H1 antihistamines available in Poland. RESULTS: Out of 2280 analyzed e-prescriptions on orally administered antihistamines, 1803 (79.1%) of them were redeemed. Therefore, the level of primary non-adherence reached 21%. Among women it reached 19.9%, but it was not significantly lower than among men (23.4%, p=0.064). The highest non-adherence (31.3%) was observed in the age group 19-39, whilst the highest adherence rate (84.6%) was observed in those 75 years or older. The most frequently prescribed second-generation antihistamine was bilastine-596 e-prescriptions with 23.7% primary non-adherence. CONCLUSIONS: More than 1 out of 5 e-prescriptions on orally administered H1-antihistamines were not redeemed in Poland in 2018. Age, but not gender, significantly influenced the degree of primary non-adherence to these drugs. To authors knowledge, this is the first real-life study on primary non-adherence to H1-antihistamines in Poland and one of the very few on this subject worldwide.