Case Presentation By: Marshall Fordyce, Senior Chief Resident
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In this cohort study, 15,961 patients were followed along with all of their incident prescriptions from primary care clinic between 2006-2009. Primary nonadherence was defined as not filling an incident prescription within 9 months. Results showed that 37, 506 incident prescriptions were written within that timeframe out of which 31.3% were not filled. More expensive medications were least likely to be filled (OR 1.11, 95% CI 1.07-1.17) as well as dermatological agents, gastrointestinal drugs and autonomic medications compared to antibiotic drugs. Decreased odds of nonadherence was associated with increasing patient age (OR per 10 years, 0.89, CI 0.85-9.92), no co-payments for prescriptions for low-income groups (OR 0.37, CI 0.32-0.41), and having most of the clinic visits with the prescribing physician (OR per 0.5 increase, 0.77, CI 0.70-0.85). Thus, nonadherence may be reduced by prescribing more inexpensive medications, eliminating co-payments for low-income patients, and scheduling more follow-up care with the prescribing physician.
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