Pottegård Anton, Christensen Rene dePont, Houji Alae, Christiansen Camilla Binderup, Paulsen Maja Skov, Thomsen Janus Laust, Hallas Jesper
Clinical Pharmacology, Institute of Public Health, University of Southern Denmark, JB Winsløwsvej 19, 2, 5000, Odense C, Denmark,
Eur J Clin Pharmacol. 2014 Jun;70(6):757-63. doi: 10.1007/s00228-014-1677-y. Epub 2014 Apr 23.
The aim of this study was to describe primary non-adherence (PNA) in a Danish general practitioner (GP) setting, i.e. the extent to which patients fail to fill the first prescription for a new drug. We also assessed the length of time between the issuing of a prescription by the GP and the dispensing of the drug by the pharmacist. Lastly, we sought to identify associations between PNA and the characteristics of the patient, the drug and the GP.
By linking data on issued prescriptions compiled in the Danish General Practice Database with data on redeemed prescriptions contained in the Danish National Prescription Registry, we calculated the rate of PNA among Danish patients from January 2011 through to August 2012. Characteristics associated with PNA were analysed using a mixed effects logistic regression model.
A total of 146,959 unique patients were started on 307,678 new treatments during the study period. The overall rate of PNA was 9.3 %, but it varied according to the major groups of the Anatomical Therapeutic Chemical (ATC) Classification System, ranging from 16.9 % for "Blood and bloodforming organs" (ATC group B) to 4.7 % for "Cardiovascular system" (ATC group C). Most of the patients redeemed their prescriptions within the first week. Older age, high income and a diagnosis of chronic obstructive pulmonary disease were found to be significantly associated with lower rates of PNA, while polypharmacy and a diagnosis of ischaemic heart disease were associated with higher rates of PNA.
The overall rate of PNA among Danish residents in a GP setting was 9.3 %. Certain drug classes and patient characteristics were associated with PNA.
本研究旨在描述丹麦全科医生（GP）环境下的初次不依从（PNA）情况，即患者未取新药物首张处方的程度。我们还评估了全科医生开具处方与药剂师配药之间的时间长度。最后，我们试图确定PNA与患者、药物及全科医生特征之间的关联。
通过将丹麦全科医疗数据库中汇编的已开具处方数据与丹麦国家处方登记处包含的已取药处方数据相链接，我们计算了2011年1月至2012年8月丹麦患者中的PNA发生率。使用混合效应逻辑回归模型分析与PNA相关的特征。
在研究期间，共有146,959名不同患者开始了307,678种新治疗。PNA的总体发生率为9.3%，但根据解剖治疗化学（ATC）分类系统的主要类别而有所不同，范围从“血液及造血器官”（ATC组B）的16.9%到“心血管系统”（ATC组C）的4.7%。大多数患者在第一周内取药。发现年龄较大、高收入以及慢性阻塞性肺疾病诊断与较低的PNA发生率显著相关，而多重用药和缺血性心脏病诊断与较高的PNA发生率相关。
丹麦居民在全科医生环境下的PNA总体发生率为9.3%。某些药物类别和患者特征与PNA相关。
