Patient compliance in filling prescriptions after discharge from the emergency department.

Frequently, emergency department treatment consists of prescriptions given to a patient at discharge on the assumption that they will be filled promptly and the medications begun as directed. Although the plan depends on the validity of this assumption, many patients may be unable (or unwilling) to fill their prescriptions. This study was undertaken to determine the prevalence of and reasons for noncompliance in filling prescriptions among patients discharged from the emergency department and to determine if differences in compliance exist among various socioeconomic groups. Ninety-six consecutive patients who had been given prescriptions at discharge from the emergency department were contacted by telephone the following day to determine if their prescriptions had been filled and if not, the reasons for not filling them. Patients were stratified by payor classification groups as follows: insured by third-party payor (53 patients), covered by Medicaid (19 patients), noninsured "self-paying", (14 patients), covered by Medicare (four patients), and unknown payor status, (six patients). The percentages in each group who had not filled their prescriptions by follow-up the next day were as follows: insured, 21%; Medicaid, 21%; self-paying, 21%; Medicare, 25%; unknown, 50%. Differences between groups were not significant. The following reasons were given for not having filled prescriptions: insufficient funds, 36%; lack of transportation or assistance, 14%; negligence, 32%; and miscellaneous, 18%. Of the prescriptions not filled, 45% were for analgesics or muscle relaxants, 41% were for antibiotics, and 14% were for miscellaneous medications.(ABSTRACT TRUNCATED AT 250 WORDS)