Faculty of Pharmacy, 1050 avenue de la Médecine, Université Laval, Québec, QC, Canada G1V 0A6; Chair on adherence to treatments, Université Laval, Québec, QC, Canada G1V 0A6; Santé des populations: URESP, Centre de recherche du CHU de Québec, 1050 Chemin Ste-Foy, Québec, QC, Canada G1S 4L8.
Res Social Adm Pharm. 2013 Nov-Dec;9(6):806-16. doi: 10.1016/j.sapharm.2013.01.007. Epub 2013 Mar 20.
Community pharmacists can use medication records to assist individuals who are loyal to their pharmacy in better managing their pharmacotherapy. However, the extent of community pharmacy loyalty among individuals with severe mental illness such as schizophrenia remains unknown.
To assess the extent of community pharmacy loyalty among individuals with schizophrenia and identify factors associated with loyalty.
Using the Quebec Health Insurance Board databases, a cohort study of individuals with schizophrenia who claimed an antipsychotic drug for the first time between January 1, 2001 and December 31, 2005 was conducted. Such individuals were considered loyal to their community pharmacy if they filled all their prescriptions for any drug at the same community pharmacy during the second year after antipsychotics initiation. Logistic regression models were used to identify factors associated with community pharmacy loyalty (measured in the first year after antipsychotics initiation).
Of the 6159 individuals in the study, 57.8% were loyal to one pharmacy. Men were more likely to be loyal (Adjusted OR = 1.29; 95% CI = 1.16-1.44), as were individuals aged 30-64 years and those aged ≥65 years, when compared to individuals 20-29 years (1.70; 1.48-1.95 and 2.39; 1.97-2.90, respectively). Individuals who filled their antipsychotics on a weekly basis were also more likely to be loyal (1.39; 1.18-1.63). Factors associated with non-loyalty were welfare beneficiary status (0.79; 0.70-0.89), having substance-use disorder (0.69; 0.60-0.80), a greater number of different types of drugs (5-8 types = 0.76; 0.66-0.87; 9-51 = 0.59; 0.50-0.69), and emergency department visits (0.71; 0.60-0.82).
Results suggest that medication records in community pharmacies are incomplete for 42.2% of individuals with schizophrenia. Individuals more likely to experience more severe illness were also those less likely to be loyal. Given the potentially severe consequences of medication-related problems in this latter population, strategies to further improve the comprehensiveness of medication information should be promoted.
社区药剂师可以利用用药记录来帮助忠于其所在药房的个人更好地管理他们的药物治疗。然而，对于精神分裂症等严重精神疾病患者的社区药房忠诚度程度尚不清楚。
评估精神分裂症患者的社区药房忠诚度程度，并确定与忠诚度相关的因素。
利用魁北克省健康保险委员会数据库，对 2001 年 1 月 1 日至 2005 年 12 月 31 日期间首次开处一种抗精神病药物的精神分裂症患者进行队列研究。如果个体在抗精神病药物治疗开始后的第二年内在同一家社区药房开处所有药物的处方，则认为其忠于该社区药房。使用逻辑回归模型来确定与社区药房忠诚度相关的因素（在抗精神病药物治疗开始后的第一年进行衡量）。
在研究的 6159 名个体中，有 57.8%的个体忠于一家药房。男性更有可能忠诚（调整后的 OR = 1.29；95%CI = 1.16-1.44），30-64 岁和≥65 岁的个体也比 20-29 岁的个体更有可能忠诚（1.70；1.48-1.95 和 2.39；1.97-2.90）。每周开处抗精神病药物的个体也更有可能忠诚（1.39；1.18-1.63）。与不忠诚相关的因素包括福利受惠者身份（0.79；0.70-0.89）、存在物质使用障碍（0.69；0.60-0.80）、使用更多不同类型的药物（5-8 种类型=0.76；0.66-0.87；9-51 种类型=0.59；0.50-0.69）和急诊就诊（0.71；0.60-0.82）。
结果表明，在 42.2%的精神分裂症患者中，社区药房的用药记录不完整。更有可能经历更严重疾病的个体也更不可能忠诚。鉴于在这一人群中药物相关问题可能产生严重后果，应推广进一步提高药物信息全面性的策略。
