TY - JOUR T1 - Medication adherence and clinical outcomes in dispensing and non-dispensing practices: a cross-sectional analysis JF - British Journal of General Practice JO - Br J Gen Pract SP - e55 LP - e61 DO - 10.3399/bjgp20X713861 VL - 71 IS - 702 AU - Mayam Gomez-Cano AU - Bianca Wiering AU - Gary Abel AU - John L Campbell AU - Christopher E Clark Y1 - 2021/01/01 UR - http://bjgp.org/content/71/702/e55.abstract N2 - Background Most patients obtain medications from pharmacies by prescription, but rural general practices can dispense medications. The clinical implications of this difference in drug delivery are unknown. This study hypothesised that dispensing status may be associated with better medication adherence. This could impact intermediate clinical outcomes dependent on medication adherence in, for example, hypertension or diabetes.Aim To investigate whether dispensing status is associated with differences in achievement of Quality and Outcomes Framework (QOF) indicators that rely on medication adherence.Design and setting Cross-sectional analysis of QOF data for 7392 general practices in England.Method QOF data from 1 April 2016 to 31 March 2017 linked to dispensing status for general practices with list sizes ≥1000 in England were analysed. QOF indicators were categorised according to whether their achievement depended on a record of prescribing only, medication adherence, or neither. Differences were estimated between dispensing and non-dispensing practices using mixed-effects logistic regression, adjusting for practice population age, sex, deprivation, list size, single-handed status, and rurality.Results Data existed for 7392 practices; 1014 (13.7%) could dispense. Achievement was better in dispensing practices than in non-dispensing practices for seven of nine QOF indicators dependent on adherence, including blood pressure targets. Only one of ten indicators dependent on prescribing but not adherence displayed better achievement; indicators unrelated to prescribing showed a trend towards higher achievement by dispensing practices.Conclusion Dispensing practices may achieve better clinical outcomes than prescribing practices. Further work is required to explore underlying mechanisms for these observations and to directly study medication adherence rates. ER -