Do accident and emergency patients collect their prescribed medication?

Freeman, Clare; Guly, H R

doi:10.1136/emj.2.1.41

Cited by 20 publications

(9 citation statements)

References 2 publications

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“…The rate of prescription noncompliance for our pediatric population more closely resembles those observed in studies of adult ED patients. [20][21][22]30 Subtypes of ''insurance status,'' the only significant predictor identified through multivariable analysis in our study, have been previously shown to be associated to medication noncompliance in adult ED populations. 22 Guardians were considered noncompliant if prescribed medications were not obtained within two days of the ED visit.…”

Section: Discussionmentioning

confidence: 58%

Socioeconomic Disparities Are Negatively Associated with Pediatric Emergency Department Aftercare Compliance

Wang

Gisondi

Golzari

et al. 2003

Academic Emergency Medicine

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Objectives: This study sought to identify demographic, socioeconomic, and clinical predictors of aftercare noncompliance by pediatric emergency department (ED) patients. Methods: The authors conducted a prospective, observational study of pediatric patients presenting to a university teaching hospital ED from July 1, 2002, through August 31, 2002. Demographic and clinical information was obtained from guardians during the ED visit. Guardians were contacted after discharge to determine compliance with ED aftercare instructions. Subjects were excluded if they were admitted or if guardians were unavailable or unwilling to consent. Data were analyzed using multivariable logistic regression to identify predictors of noncompliance from a list of predetermined variables. Results: Of the 409 patients enrolled in the study, 111 were prescribed medications and 364 were given specific follow-up instructions. Subtypes of the variable ''insurance status'' were significantly associated with medication noncompliance in multivariable regression analysis. ''Insurance status'' and ''low-acuity discharge diagnoses'' were significantly associated with follow-up noncompliance. Conclusions: Disparity in health insurance has been shown to be a predictor of poor aftercare compliance for pediatric ED patients within the patient population.

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Section: Discussionmentioning

confidence: 58%

Socioeconomic Disparities Are Negatively Associated with Pediatric Emergency Department Aftercare Compliance

Wang

Gisondi

Golzari

et al. 2003

Academic Emergency Medicine

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“…The results are consistent with studies from EDs and nonpediatric primary care, showing rates of unfilled prescriptions ranging from 16% to 35% and 16% to 24%, respectively. [5][6][7][8]12,13 Our findings suggest that nondemographic factors, such as the method of prescribing (electronic versus paper), clinic site, medication This study did not show a significant association between child age and prescription filling. A previous study of 65 patients also found a lack of significant association, but it may have been too small to detect a difference.…”

Section: Discussionmentioning

confidence: 40%

“…Claims data for adult ED prescriptions demonstrate that 16% to 25% of prescriptions are not filled. [5][6][7] Studies from pediatric EDs demonstrate rates of unfilled prescriptions from 7% based on survey data 8 to 35% by using claims data. 9 Primary medication nonadherence also occurs in a primary care setting.…”

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confidence: 99%

Unfilled Prescriptions in Pediatric Primary Care

2012

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WHAT'S KNOWN ON THIS SUBJECT: Filling a prescription is the first step in medication adherence. Unfilled prescriptions are a documented component of nonadherence in adult and pediatric emergency departments and family practices. No one has reported the proportion of unfilled prescriptions in pediatric primary care. WHAT THIS STUDY ADDS:This study identifies the proportion of unfilled prescriptions in a large sample of primary care pediatric patients. It describes clinical and demographic factors associated with prescription filling and suggests that electronic prescribing may improve adherence. abstract 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 16 953 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. Pediatrics 2012;130:620-626 AUTHORS:

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“…Previous studies using pharmacy data to determine adult emergency department prescription fill rates showed rates ranging from 74-84%, 48,54,56 with one as low as 19.8%. 57 Since we only 36 looked at insured patients, it was expected that our fill rates would actually be higher than those seen previously.…”

Section: Discussionmentioning

confidence: 99%

228 Comparison of Primary Compliance in Electronic Versus Paper Prescriptions Prescribed From the Emergency Department

Andrusaitis¹,

Billimek²,

Osborn³

et al. 2017

Annals of Emergency Medicine

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The Medicare Improvements for Patients and Providers Act passed by Congress in 2008has changed prescribing practices in the United States. Electronic prescriptions (e-prescriptions) have now become the most widely used form of prescriptions. The government in fact financially discourages the use of the older more traditional paper prescriptions.Many emergency medicine physicians fear that this blanket policy is not in the best interests of their unique patient population. It is the belief of many of these physicians that emergency patients are more likely to fill paper prescriptions than e-prescriptions. This theory is predicated on the knowledge that many emergency patients are less established in the system and their visits are frequently rushed, chaotic, and unplanned. For these reasons, the e-prescription system is not ideal for them and the theorized consequence is that many e-prescriptions go unfilled, leaving patients to go untreated.A retrospective analysis was conducted at the emergency department of the University of California, Irvine Medical Center to identify insured adult patients who were given a noncontrolled substance prescription in either the paper or electronic form. Pharmacy claim data to vi insurances was used to determine whether these prescriptions were filled. 405 encounters were included, 218 of which included e-prescriptions and 187 of which included paper prescriptions.Our findings showed that paper prescriptions are filled at the same rate as electronic prescriptions (58.3% versus 57.8% p=1). These results were surprising as they contradicted what many physicians believe is the situation. More studies are needed in order to be able to broaden these results to the entire emergency medicine patient population, but these results may begin to alter prescription practices in emergency medicine.

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Do accident and emergency patients collect their prescribed medication?

Cited by 20 publications

References 2 publications

Socioeconomic Disparities Are Negatively Associated with Pediatric Emergency Department Aftercare Compliance

Socioeconomic Disparities Are Negatively Associated with Pediatric Emergency Department Aftercare Compliance

Unfilled Prescriptions in Pediatric Primary Care

228 Comparison of Primary Compliance in Electronic Versus Paper Prescriptions Prescribed From the Emergency Department

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