| The epidemiology of prescriptions abandoned at the pharmacy. | |
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MedLine Citation:
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PMID: 21079218 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Picking up prescriptions is an essential but previously unstudied component of adherence for patients who use retail pharmacies. Understanding the epidemiology and correlates of prescription abandonment may have an important effect on health care quality. OBJECTIVE: To evaluate the rates and correlates of prescription abandonment. DESIGN: Cross-sectional cohort study. SETTING: One large retail pharmacy chain and one large pharmacy benefits manager (PBM) in the United States. MEASUREMENTS: Prescriptions bottled at the retail pharmacy chain between 1 July 2008 and 30 September 2008 by patients insured by the PBM were identified. Pharmacy data were used to identify medications that were bottled and either dispensed or returned to stock (RTS) or abandoned. Data from the PBM were used to identify previous or subsequent dispensing at any pharmacy. The first (index) prescription in a class for each patient was assigned to 1 of 3 mutually exclusive outcomes: filled, RTS, or RTS with fill (in the 30 days after abandonment, the patient purchased a prescription for a medication in the same medication class at any pharmacy). Outcome rates were assessed by drug class, and generalized estimating equations were used to assess patient, neighborhood, insurance, and prescription characteristics associated with abandonment. RESULTS: 10 349 139 index prescriptions were filled by 5 249 380 patients. Overall, 3.27% of index prescriptions were abandoned; 1.77% were RTS and 1.50% were RTS with fill. Patients were least likely to abandon opiate prescriptions. Prescriptions with copayments of $40 to $50 and prescriptions costing more than $50 were 3.40 times and 4.68 times more likely, respectively, to be abandoned than prescriptions with no copayment (P < 0.001 for both comparisons). New users of medications had a 2.74 times greater probability of abandonment than prevalent users (P < 0.001), and prescriptions delivered electronically were 1.64 times more likely to be abandoned than those that were not electronic (P < 0.001). LIMITATION: The study included mainly insured patients and analyzed data collected during the summer months only. CONCLUSION: Although prescription abandonment represents a small component of medication nonadherence, the correlates to abandonment highlight important opportunities to intervene and thereby improve medication taking. PRIMARY FUNDING SOURCE: CVS Caremark. |
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Authors:
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William H Shrank; Niteesh K Choudhry; Michael A Fischer; Jerry Avorn; Mark Powell; Sebastian Schneeweiss; Joshua N Liberman; Timothy Dollear; Troyen A Brennan; M Alan Brookhart |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Annals of internal medicine Volume: 153 ISSN: 1539-3704 ISO Abbreviation: Ann. Intern. Med. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-16 Completed Date: 2010-12-07 Revised Date: 2011-07-05 |
Medline Journal Info:
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Nlm Unique ID: 0372351 Medline TA: Ann Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 633-40 Citation Subset: AIM; IM |
Affiliation:
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Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02120, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Child Child, Preschool Cross-Sectional Studies Drug Prescriptions / economics, statistics & numerical data* Female Humans Infant Infant, Newborn Male Medication Adherence / statistics & numerical data* Middle Aged Pharmacies / economics, statistics & numerical data* Prescription Fees / statistics & numerical data United States Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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AG-027400/AG/NIA NIH HHS; HL-090505/HL/NHLBI NIH HHS; K23 HL090505-05/HL/NHLBI NIH HHS |
| Comments/Corrections | |
Comment In:
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Ann Intern Med. 2011 May 17;154(10):706; author reply 706-7
[PMID:
21576546
]
Ann Intern Med. 2010 Nov 16;153(10):680-1 [PMID: 21079227 ] Ann Intern Med. 2011 May 17;154(10):705-6; author reply 706-7 [PMID: 21576543 ] |
Summary for patients in:
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Ann Intern Med. 2010 Nov 16;153(10):I42
[PMID:
21079203
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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