Undispensed prescriptions in a mining general practice.

Waters, Warwick; Gould, Nathaniel; Lunn, John E.

doi:10.1136/bmj.1.6017.1062

Cited by 24 publications

(11 citation statements)

References 0 publications

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“…This is similar to previous research on unclaimed prescriptions in which the classes most frequently reported as having the highest percentage of unclaimed scripts included psychiatric medications (sometimes called central nervous system [CNS] drugs), analgesics, contraceptives, and antibiotics. 1,[3][4][5]7,8,[10][11][12][13][14][15]20,26,27,41,[47][48][49] Differences in research methods between the present study and previous research may explain why antibiotics, which comprised 1.6% of unclaimed fills, were not among the top 3 unclaimed prescription classes reported for this research population. By using 12 months of data on prescription drug orders and dispensings, the present study was not affected by seasonal drug utilization that is likely more common for antibiotics than other drug classes, while other studies that use fewer than 12 months of data (in some cases, 1 or 2 months) are potentially more affected by seasonal patterns of drug use.…”

Section: ■■ Discussioncontrasting

confidence: 53%

“…The levels of unclaimed prescriptions across drug classes primarily associated with chronic and acute medical conditions were examined because unclaimed prescriptions most often are associated with use of medications for acute conditions. 1,[3][4][5]7,8,[10][11][12][13][14][15]20,26,27,41 ■■ Results Between May and July 2004, telephone interviews with 1,214 TRICARE beneficiaries were completed, with a response rate of 60.6% (attempts were made to contact 2,004 patients in total to reach a target of 200 completed interviews per study pharmacy). From March to July 2004, respondents filled nearly 7 prescriptions, on average.…”

Section: Analysis Of Survey Datamentioning

confidence: 99%

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Prevalence of Unclaimed Prescriptions at Military Pharmacies

Esposito¹,

Schöne²,

Williams³

et al. 2008

JMCP

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BACKGROUND: Prescriptions that are ordered by physicians but not picked up by patients represent a potential quality improvement opportunity in health systems. Previous research has demonstrated that anywhere from as little as 0.28% to as much as 30.0% of prescriptions are unclaimed, and that 0.45% to 22.0% of patients fail to claim prescriptions. In the Military Health System (MHS), prescriptions filled at military pharmacies are dispensed with no copayment, providing an opportunity to examine the factors that contribute to unclaimed prescriptions other than out-of-pocket cost.OBJECTIVES: To estimate the prevalence of unclaimed prescriptions in the MHS, investigate reasons for unclaimed prescriptions, and compare self-reported noncompliance, defined as the failure to pick up at least 1 prescription in a 12-month period, with evidence from an administrative database of prescription orders and dispensings.METHODS: Research methods included pharmacy staff interviews at 6 military pharmacies, a telephone survey of beneficiaries who filled prescriptions at these pharmacies, descriptive analysis of survey data, and comparison of administrative pharmacy data with self-reported survey data. Beneficiary interviews, conducted from May through July 2004, covered background characteristics, medical conditions, and unclaimed prescriptions, relying on 12 months of recall regarding noncompliance. Interviews with pharmacy staff covered day-to-day operations, factors that alleviate or exacerbate noncompliance, and the burden that noncompliance places on pharmacies. Administrative data from the Pharmacy Data Transaction Service (pharmacy claims) and Composite Health Care System (CHCS: prescription orders and dispensings) databases were used to select a random sample for the beneficiary survey. Survey respondents' CHCS data were matched to their responses to determine the degree of agreement between self-reports and administrative data.RESULTS: Pharmacy interviews were completed with 30 staff members at 6 military pharmacies, and telephone interviews were completed with 1,214 beneficiaries (60.6% response rate). Beneficiary respondents filled an average of 7 prescriptions in the 5 months approximately surrounding the survey administration time frame (from March to July 2004). More than half (56.8%) of respondents were female, and nearly 60.6% were retired military or their dependents. Among all respondents at all study pharmacies, 8.0% reported failing to claim at least 1 prescription during the prior 12 months. Among survey respondents deemed compliant by CHCS data, 93.8% correctly identified themselves as compliant. However, among patients identified as noncompliant using CHCS data, only 16.0% selfidentified as noncompliant. The administrative data were not concordant with self-report data: of 105 survey respondents identifying themselves as noncompliant in the prior year and matched to administrative data (CHCS), only 58.1% were noncompliant per administrative data, and of 1,065 selfidentifying as compliant, only 61.1%...

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Section: ■■ Discussioncontrasting

confidence: 53%

Section: Analysis Of Survey Datamentioning

confidence: 99%

Prevalence of Unclaimed Prescriptions at Military Pharmacies

Esposito¹,

Schöne²,

Williams³

et al. 2008

JMCP

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show abstract

“…It has been found that overall (that is, all prescriptions and all therapeutic groups), between 7% and 20% of patients fail to redeem their prescription at the pharmacy. [14][15][16] These studies, however, do not provide insight into the non-filling of antidepressant prescriptions, and first-time prescriptions in particular. Furthermore, it has been shown that of all patients having an antidepressant dispensed at the pharmacy, up to 38% fill only a single prescription.…”

Section: Introductionmentioning

confidence: 99%

Initiation of antidepressant therapy: do patients follow the GP's prescription?

Geffen¹,

Gardarsdóttir²,

Hulten³

et al. 2009

Br J Gen Pract

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Retrospective study linking a general practice to a pharmacy dispensing database. SettingGeneral practice in the Netherlands. MethodStudy population: patients who received a first-time antidepressant prescription from a GP. Three patient groups were identified: patients who did not fill the prescription (non-fillers); patients who filled only a single prescription (single Rx-fillers); and patients who filled at least two consecutive prescriptions. Non-fillers and single Rx-fillers were combined into a group of decliners. ResultsOf all 965 patients, 41 (4.2%) did not fill the prescription, and 229 (23.7%) filled only a single prescription. Patients who consulted their GP for a non-specific indication, rather than for depression, anxiety, panic, or obsessive-compulsive disorder, were almost three times more likely (odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.8 to 3.9) to decline treatment. Further, the risk of declining was almost fivefold higher (OR = 4.8, 95% CI = 2.1 to 11.3) in nonWestern immigrants, and almost twofold higher (OR = 1.8, 95% CI = 1.2 to 2.8) in patients >60 years of age. ConclusionOver one in four patients who receive a first-time antidepressant prescription decline treatment; they either do not initiate drug taking or do not persist with antidepressant use for longer than 2 weeks.

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“…Primary non-compliance with medication -patients failing even to redeem their prescriptions -has been found to occur for 6 -20% of primary care prescriptions [3][4][5][6]. Even when prescriptions are redeemed doses are delayed or omitted in 30 -50% of cases [7].…”

Section: Introductionmentioning

confidence: 99%