Evaluation of Primary Prescription Nonadherence Post-discharge from an Inpatient Psychiatry Unit at a Large Urban Community Hospital – an Observational Study

Abstract

Introduction: Here, we aimed to evaluate primary prescription nonadherence post-discharge from an acute inpatient psychiatric unit. Prescription nonadherence is a concern across all patient care settings, with primary nonadherence defined as not picking up prescribed medication from the pharmacy or not delivering prescriptions to the pharmacy. Secondary nonadherence, defined as filling a prescription but not taking the medication as prescribed, was not tracked in this study. The incidence of nonadherence can vary widely across settings and has been reported to range from 3 to 86%. This is a particular concern in patients with a primary psychiatric diagnosis both in an outpatient and inpatient setting. Design: The prescription fill rate of eligible patients was tracked on days 7 and 21 post-discharge from acute inpatient psychiatric units of an acute care multispecialty urban community teaching hospital. Results: In total, 72 patients aged 18 and above (44%, women) were analyzed. A primary nonadherence incidence of 43% was found, which did not vary significantly across the analyzed variables of age, sex, or primary diagnosis. Conclusion: Primary nonadherence is a significant issue in this population. Strategies, such as the implementation of med-to-bed programs and use of longer acting injectables when appropriate, would help in increasing adherence. Further research, including the evaluation of other variables that affect nonadherence, is needed in order to identify and develop steps to overcome the obstacles to adherence.