Sammons Nicole Willis, Yin Han
From the *Department of Emergency Medicine, and †Biostatistics Core, Nationwide Children's Hospital, Columbus, OH.
Pediatr Emerg Care. 2015 Jun;31(6):399-402. doi: 10.1097/PEC.0000000000000456.
Studies regarding compliance of medications prescribed from emergency departments (EDs) have primarily been adult-based or based on self-reported data. Most pediatric studies have shown that patients with private insurance tend to be more compliant. This study aims to determine the rate of medication compliance from a pediatric ED, which medications are most likely to be filled, if there are differences in compliance based on insurance status and age, and if noncompliant patients are more likely to have unintended return visits to the ED.
In this retrospective chart review, a sample of consecutive pediatric patients discharged from the ED was obtained. Pharmacies were contacted to ensure prescriptions were filled. Medication compliance was inferred if a prescription was filled.
The 152 patients included had a total of 229 prescriptions that were used for data analysis. The overall medication compliance rate was 72.5%. There was no statistically significant difference in medication compliance between age (P = 0.9), diagnosis (P = 0.26), insurance status (P = 0.3), or type of medication (P = 0.3). No difference was demonstrated for unintended return visits based on compliance (P = 0.79).
Over a quarter of patients prescribed medications were noncompliant. However, there was no statistically significant difference in compliance between age, diagnosis, insurance status, or type of medication. Unlike most previous studies, privately insured patients were just as unlikely to fill their medications as publicly insured patients, and cost did not appear to be a contributing factor to noncompliance. Therefore efforts to educate patients and their families should be widespread and unbiased.
关于急诊科开具药物的依从性研究主要以成人为基础或基于自我报告数据。大多数儿科研究表明,拥有私人保险的患者往往依从性更高。本研究旨在确定儿科急诊科的药物依从率,哪些药物最有可能被配药,依从性是否因保险状况和年龄存在差异,以及未依从的患者是否更有可能意外返回急诊科。
在这项回顾性病历审查中,获取了从急诊科出院的连续儿科患者样本。联系药房以确保处方被配药。如果处方被配药,则推断为药物依从。
纳入的152名患者共有229张处方用于数据分析。总体药物依从率为72.5%。年龄(P = 0.9)、诊断(P = 0.26)、保险状况(P = 0.3)或药物类型(P = 0.3)之间的药物依从性无统计学显著差异。基于依从性的意外返回就诊无差异(P = 0.79)。
超过四分之一的开具药物处方的患者未依从。然而,年龄、诊断、保险状况或药物类型之间的依从性无统计学显著差异。与大多数先前研究不同,拥有私人保险的患者配药的可能性与拥有公共保险的患者一样低,费用似乎不是导致不依从的因素。因此,对患者及其家属的教育工作应广泛且无偏见。