Primary medication non-adherence at Counties Manukau Health Emergency Department (CMH-ED), New Zealand: an observational study

ObjectivesTo measure primary medication non-adherence (failure to fill prescription medicines) in patients discharged from the emergency department (ED), and to determine whether sociodemographic factors, smoking status and access to a general practitioner affect prescription filling. Little is know...

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Published in:BMJ open 2020-07, Vol.10 (7), p.e035775-e035775
Main Authors: Martini, Nataly Dominica, van der Werf, Bert, Bassett-Clarke, Deborah
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
Child
Cross-Sectional Studies
Data collection
Drug stores
Emergency Medicine
Emergency Service, Hospital - organization & administration
Emergency Service, Hospital - statistics & numerical data
Ethnicity
Female
Gender
Health care policy
Hospitals
Humans
Male
Medical research
Medication Adherence - psychology
Medication Adherence - statistics & numerical data
Middle Aged
Multivariate Analysis
New Zealand
Observational studies
Occupations - statistics & numerical data
Patient compliance
Pharmacy
Prescriptions
Public health
Socioeconomic factors
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van der Werf, Bert
Bassett-Clarke, Deborah
description ObjectivesTo measure primary medication non-adherence (failure to fill prescription medicines) in patients discharged from the emergency department (ED), and to determine whether sociodemographic factors, smoking status and access to a general practitioner affect prescription filling. Little is known about primary medication non-adherence in EDs, and less so in New Zealand (NZ). Identifying reasons for non-adherence will enable development of strategies to improve adherence and reduce morbimortality.Design and settingAn observational study based on patient data from the ED of a large public hospital in South Auckland, NZ.ParticipantsData were collected from 1600 patients discharged between 28 April–6 May and 28 July–9 August 2014. Data were included if patients were residents within the Auckland Regional Public Health Service boundaries, admitted to ED and discharged with a prescription. Data were excluded if patients were admitted to another ward, transferred to another hospital or left the ED without seeing a doctor.Results992 patients were included in the study, the majority were under 10 years (32.6%), of Pacific Island descent (42.8%), NZ-born (67.7%) and living in the most socioeconomically deprived areas (78.1%). Almost 50% of patients failed to fill all prescription medications. Simple linear regression analysis indicated that non-adherence was significant for those 10–24 years (n=236; adherence=47.2%; p
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Little is known about primary medication non-adherence in EDs, and less so in New Zealand (NZ). Identifying reasons for non-adherence will enable development of strategies to improve adherence and reduce morbimortality.Design and settingAn observational study based on patient data from the ED of a large public hospital in South Auckland, NZ.ParticipantsData were collected from 1600 patients discharged between 28 April–6 May and 28 July–9 August 2014. Data were included if patients were residents within the Auckland Regional Public Health Service boundaries, admitted to ED and discharged with a prescription. Data were excluded if patients were admitted to another ward, transferred to another hospital or left the ED without seeing a doctor.Results992 patients were included in the study, the majority were under 10 years (32.6%), of Pacific Island descent (42.8%), NZ-born (67.7%) and living in the most socioeconomically deprived areas (78.1%). Almost 50% of patients failed to fill all prescription medications. Simple linear regression analysis indicated that non-adherence was significant for those 10–24 years (n=236; adherence=47.2%; p<0.05), of NZ Māori ethnicity (n=175; 51.3%; p=0.01), unemployed (n=77; 46.8%; p<0.01), homemakers (n=66; 45.7%; p<0.01), students (n=228; 55.6%; p<0.05) and cigarette smokers (n=139; 50.3%; p<0.01). Following multivariable analysis, the strongest predictors for non-adherence were those aged between 10 and 17 years (n=116; p<0.01), the unemployed (n=77; p=0.01) and homemakers (n=66; p=0.01).ConclusionsAge and occupation were the greater predictors of non-adherence; however, no other significant differences were found. Since this study, changes to prescription co-payments have been made. Further research is warranted to assess whether this change has more recently affected the rates of non-adherence.]]></description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2019-035775</identifier><identifier>PMID: 32737089</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adolescent ; Adult ; Age ; Child ; Cross-Sectional Studies ; Data collection ; Drug stores ; Emergency Medicine ; Emergency Service, Hospital - organization &amp; administration ; Emergency Service, Hospital - statistics &amp; numerical data ; Ethnicity ; Female ; Gender ; Health care policy ; Hospitals ; Humans ; Male ; Medical research ; Medication Adherence - psychology ; Medication Adherence - statistics &amp; numerical data ; Middle Aged ; Multivariate Analysis ; New Zealand ; Observational studies ; Occupations - statistics &amp; numerical data ; Patient compliance ; Pharmacy ; Prescriptions ; Public health ; Socioeconomic factors</subject><ispartof>BMJ open, 2020-07, Vol.10 (7), p.e035775-e035775</ispartof><rights>Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2020 Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. 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Published by BMJ. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b4893-3043efb752ffb4e0a44b50febbc18f2ad0956b28146c4c64099ae19616f7aa743</citedby><cites>FETCH-LOGICAL-b4893-3043efb752ffb4e0a44b50febbc18f2ad0956b28146c4c64099ae19616f7aa743</cites><orcidid>0000-0002-9900-8883 ; 0000-0003-3072-5937</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2429377302/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2429377302?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>112,113,230,314,727,780,784,885,3194,25753,27549,27550,27924,27925,37012,37013,44590,53791,53793,75126,77594,77595,77601,77632</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32737089$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martini, Nataly Dominica</creatorcontrib><creatorcontrib>van der Werf, Bert</creatorcontrib><creatorcontrib>Bassett-Clarke, Deborah</creatorcontrib><title>Primary medication non-adherence at Counties Manukau Health Emergency Department (CMH-ED), New Zealand: an observational study</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description><![CDATA[ObjectivesTo measure primary medication non-adherence (failure to fill prescription medicines) in patients discharged from the emergency department (ED), and to determine whether sociodemographic factors, smoking status and access to a general practitioner affect prescription filling. Little is known about primary medication non-adherence in EDs, and less so in New Zealand (NZ). Identifying reasons for non-adherence will enable development of strategies to improve adherence and reduce morbimortality.Design and settingAn observational study based on patient data from the ED of a large public hospital in South Auckland, NZ.ParticipantsData were collected from 1600 patients discharged between 28 April–6 May and 28 July–9 August 2014. Data were included if patients were residents within the Auckland Regional Public Health Service boundaries, admitted to ED and discharged with a prescription. Data were excluded if patients were admitted to another ward, transferred to another hospital or left the ED without seeing a doctor.Results992 patients were included in the study, the majority were under 10 years (32.6%), of Pacific Island descent (42.8%), NZ-born (67.7%) and living in the most socioeconomically deprived areas (78.1%). Almost 50% of patients failed to fill all prescription medications. Simple linear regression analysis indicated that non-adherence was significant for those 10–24 years (n=236; adherence=47.2%; p<0.05), of NZ Māori ethnicity (n=175; 51.3%; p=0.01), unemployed (n=77; 46.8%; p<0.01), homemakers (n=66; 45.7%; p<0.01), students (n=228; 55.6%; p<0.05) and cigarette smokers (n=139; 50.3%; p<0.01). Following multivariable analysis, the strongest predictors for non-adherence were those aged between 10 and 17 years (n=116; p<0.01), the unemployed (n=77; p=0.01) and homemakers (n=66; p=0.01).ConclusionsAge and occupation were the greater predictors of non-adherence; however, no other significant differences were found. Since this study, changes to prescription co-payments have been made. Further research is warranted to assess whether this change has more recently affected the rates of non-adherence.]]></description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Child</subject><subject>Cross-Sectional Studies</subject><subject>Data collection</subject><subject>Drug stores</subject><subject>Emergency Medicine</subject><subject>Emergency Service, Hospital - organization &amp; administration</subject><subject>Emergency Service, Hospital - statistics &amp; numerical data</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Gender</subject><subject>Health care policy</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Male</subject><subject>Medical research</subject><subject>Medication Adherence - psychology</subject><subject>Medication Adherence - statistics &amp; numerical data</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>New Zealand</subject><subject>Observational studies</subject><subject>Occupations - statistics &amp; 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van der Werf, Bert ; Bassett-Clarke, Deborah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b4893-3043efb752ffb4e0a44b50febbc18f2ad0956b28146c4c64099ae19616f7aa743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Child</topic><topic>Cross-Sectional Studies</topic><topic>Data collection</topic><topic>Drug stores</topic><topic>Emergency Medicine</topic><topic>Emergency Service, Hospital - organization &amp; administration</topic><topic>Emergency Service, Hospital - statistics &amp; numerical data</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Gender</topic><topic>Health care policy</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Male</topic><topic>Medical research</topic><topic>Medication Adherence - psychology</topic><topic>Medication Adherence - statistics &amp; numerical data</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>New Zealand</topic><topic>Observational studies</topic><topic>Occupations - statistics &amp; numerical data</topic><topic>Patient compliance</topic><topic>Pharmacy</topic><topic>Prescriptions</topic><topic>Public health</topic><topic>Socioeconomic factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martini, Nataly Dominica</creatorcontrib><creatorcontrib>van der Werf, Bert</creatorcontrib><creatorcontrib>Bassett-Clarke, Deborah</creatorcontrib><collection>British Medical Journal Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing &amp; Allied Health Source</collection><collection>Health &amp; Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health &amp; 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Little is known about primary medication non-adherence in EDs, and less so in New Zealand (NZ). Identifying reasons for non-adherence will enable development of strategies to improve adherence and reduce morbimortality.Design and settingAn observational study based on patient data from the ED of a large public hospital in South Auckland, NZ.ParticipantsData were collected from 1600 patients discharged between 28 April–6 May and 28 July–9 August 2014. Data were included if patients were residents within the Auckland Regional Public Health Service boundaries, admitted to ED and discharged with a prescription. Data were excluded if patients were admitted to another ward, transferred to another hospital or left the ED without seeing a doctor.Results992 patients were included in the study, the majority were under 10 years (32.6%), of Pacific Island descent (42.8%), NZ-born (67.7%) and living in the most socioeconomically deprived areas (78.1%). Almost 50% of patients failed to fill all prescription medications. Simple linear regression analysis indicated that non-adherence was significant for those 10–24 years (n=236; adherence=47.2%; p<0.05), of NZ Māori ethnicity (n=175; 51.3%; p=0.01), unemployed (n=77; 46.8%; p<0.01), homemakers (n=66; 45.7%; p<0.01), students (n=228; 55.6%; p<0.05) and cigarette smokers (n=139; 50.3%; p<0.01). Following multivariable analysis, the strongest predictors for non-adherence were those aged between 10 and 17 years (n=116; p<0.01), the unemployed (n=77; p=0.01) and homemakers (n=66; p=0.01).ConclusionsAge and occupation were the greater predictors of non-adherence; however, no other significant differences were found. Since this study, changes to prescription co-payments have been made. Further research is warranted to assess whether this change has more recently affected the rates of non-adherence.]]></abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>32737089</pmid><doi>10.1136/bmjopen-2019-035775</doi><orcidid>https://orcid.org/0000-0002-9900-8883</orcidid><orcidid>https://orcid.org/0000-0003-3072-5937</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Age
Child
Cross-Sectional Studies
Data collection
Drug stores
Emergency Medicine
Emergency Service, Hospital - organization & administration
Emergency Service, Hospital - statistics & numerical data
Ethnicity
Female
Gender
Health care policy
Hospitals
Humans
Male
Medical research
Medication Adherence - psychology
Medication Adherence - statistics & numerical data
Middle Aged
Multivariate Analysis
New Zealand
Observational studies
Occupations - statistics & numerical data
Patient compliance
Pharmacy
Prescriptions
Public health
Socioeconomic factors
title Primary medication non-adherence at Counties Manukau Health Emergency Department (CMH-ED), New Zealand: an observational study
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