RT Journal Article
SR Electronic
T1 Impact of initial medication non-adherence on use of healthcare services and sick leave: a longitudinal study in a large primary care cohort in Spain
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e614
OP e622
DO 10.3399/bjgp17X692129
VO 67
IS 662
A1 Ignacio Aznar-Lou
A1 Ana Fernández
A1 Montserrat Gil-Girbau
A1 Ramón Sabés-Figuera
A1 Marta Fajó-Pascual
A1 María Teresa Peñarrubia-María
A1 Antoni Serrano-Blanco
A1 Patricia Moreno-Peral
A1 Albert Sánchez-Niubó
A1 Marian March-Pujol
A1 Maria Rubio-Valera
YR 2017
UL http://bjgp.org/content/67/662/e614.abstract
AB Background Initial medication non-adherence is highly prevalent in primary care but no previous studies have evaluated its impact on the use of healthcare services and/or days on sick leave.Aim To estimate the impact of initial medication non-adherence on the use of healthcare services, days of sick leave, and costs overall and in specific medication groups.Design and setting A 3-year longitudinal register-based study of all primary care patients (a cohort of 1.7 million) who were prescribed a new medication in Catalonia (Spain) in 2012.Method Thirteen of the most prescribed and/or costly medication subgroups were considered. All medication and medication subgroups (chronic, analgesics, and penicillin) were analysed. The number of healthcare services used and days on sick leave were considered. Multilevel multivariate linear regression was used. Three levels were included: patient, GP, and primary care centre.Results Initially adherent patients made more use of medicines and some healthcare services than non-adherent and partially adherent patients. They had lower productivity losses, producing a net economic return, especially when drugs for acute diseases (such as penicillins) were considered. Initial medication non-adherence resulted in a higher economic burden to the system in the short term.Conclusion Initial medication non-adherence seems to have a short-term impact on productivity losses and costs. The clinical consequences and long-term economic consequences of initial medication non-adherence need to be assessed. Interventions to promote initial medication adherence in primary care may reduce costs and improve health outcomes.