Enhancing Primary Adherence to Prescribed Medications through an Organized Health Status Assessment-Based Extension of Primary Healthcare Services

Abstract

This study was part of monitoring an intervention aimed at developing a general practitioner cluster (GPC) model of primary healthcare (PHC) and testing its effectiveness in delivering preventive services integrated into the PHC system. The aim was to demonstrate whether GPC operation could increase the percentage of drugs actually dispensed. Using national reference data of the National Health Insurance Fund for each anatomical–therapeutic chemical classification ATC group of drugs, dispensed-to-prescribed ratios standardized (sDPR) for age, sex, and exemption certificate were calculated during the first quarter of 2012 (before-intervention) and the third quarter of 2015 (post-intervention). The after-to-before ratios of the sDPR as the relative dispensing ratio (RDR) were calculated to describe the impact of the intervention program. The general medication adherence increased significantly in the intervention area (RDR = 1.064; 95% confidence interval (CI): 1.054–1.073). The most significant changes were observed for cardiovascular system drugs (RDR = 1.062; 95% CI: 1.048–1.077) and for alimentary tract and metabolism-specific drugs (RDR = 1.072; 95% CI: 1.049–1.097). The integration of preventive services into a PHC without any specific medication adherence-increasing activities is beneficial for medication adherence, especially among patients with cardiovascular, alimentary tract, and metabolic disorders. Monitoring the percentage of drugs actually dispensed is a useful element of PHC-oriented intervention evaluation frames.

Is Prescription Nonredemption a Source of Poor Health Among the Roma? Cross-Sectional Analysis of Drug Consumption Data From the National Health Insurance Fund of Hungary

“…The observed 2.8% excess corresponds to 920 redemptions a year in the population of 4,943 Roma people living in the SRC. Higher redemption rates in disadvantaged populations, as indicated by low levels of education and high level of deprivation, was observed previously in Hungarian studies ( Boruzs et al, 2016 ; Boruzs et al, 2018 ; Harsha et al, 2019a ; Harsha et al, 2019b ; Juhász et al, 2020 ) and in other countries as well ( Mauskop and Borden, 2011 ; Jackson et al, 2014 ; Rosicova et al, 2015 ; Ferdinand et al, 2017 ; Pandya and Bajorek, 2017 ; Lee et al, 2018 ; Gast and Mathes, 2019 ).…”

“…Indirect standardization was applied to ensure the comparability of SRC- and CA-specific indicators. Age- and sex-specific expected proportions of redeemed prescriptions were calculated by age- and sex-specific numbers of written prescriptions and the national reference redeemed-to-written ratio for all strata ( Harsha et al, 2019a ; Harsha et al, 2019b ). To control for the confounding effect of the demographic factors, standardized redemption ratios (SRRs) were calculated by dividing accumulated age- and sex-specific numbers of observed redemptions by accumulated age- and sex-specific numbers of expected redemptions of prescribed drugs for both the SRC and the CA.…”