Kari Heini, Nurminen Fredriikka, Rättö Hanna, Koskinen Hanna
Research Unit, The Social Insurance Institution of Finland (Kela), Helsinki, Finland.
INVEST Research Centre, University of Turku, Turku, Finland.
Explor Res Clin Soc Pharm. 2024 Nov 16;16:100541. doi: 10.1016/j.rcsop.2024.100541. eCollection 2024 Dec.
Medication non-adherence is associated with suboptimal health outcomes, higher mortality, and increased healthcare costs.
The aim of this study was to estimate the number and share of non-dispensed prescriptions at a national level and in specific patient and medicine subgroups.
The study was a nationwide retrospective register-based study. The data consisted of prescriptions prescribed in Finland in 2020 and dispensed between 2020 and 2022. A prescription was considered non-dispensed if it had not been dispensed within the two-year validity period. For each prescription, information on the patient's birth date, sex, and income as well as details of the prescribed medicine and physician's employment sector (public/private) were collected. Distributions and odds ratios (ORs) with corresponding 95 % confidence intervals (CI) were used in the analyses.
Of the 26 million prescriptions, 13.3 % were never filled. Over 1.7 million people (43.3 % of all people with prescriptions issued in 2020) had at least one non-dispensed prescription. The share of non-dispensed prescriptions was lower in men than women (12.9 % vs. 13.5 %; OR:0.95; CI:0.95-0.95). Compared to the youngest age group, the share of non-dispensed prescriptions was lower in the older age groups. The lowest share of non-dispensed medicines was in antineoplastic and immunomodulating agents (7.8 %) and in cardiovascular system medicines (8.1 %), whereas the highest was in dermatologicals (20.2 %). The proportion of non-dispensed prescriptions varied between medicine groups, from 5 % for thyroid therapy to 38 % for other nervous system drugs. The most frequently non-dispensed medications were paracetamol, ibuprofen, and salbutamol.
The share and number of non-dispensed prescriptions varied across therapeutic areas, medicine groups, active pharmaceutical ingredients, and patient groups. Healthcare professionals should avoid unnecessary prescribing and improve medication adherence to ensure safer and more effective care.
药物治疗依从性不佳与健康结果不理想、死亡率较高以及医疗保健成本增加有关。
本研究的目的是估计全国范围内以及特定患者和药物亚组中未配药处方的数量和占比。
该研究是一项基于全国性回顾性登记的研究。数据包括2020年在芬兰开具并在2020年至2022年期间配药的处方。如果一张处方在两年有效期内未配药，则被视为未配药。对于每张处方，收集了患者的出生日期、性别、收入信息以及所开药物的详细信息和医生的就业部门（公立/私立）。分析中使用了分布和比值比（OR）以及相应的95%置信区间（CI）。
在2600万张处方中，13.3%从未配药。超过170万人（2020年所有开具处方患者的43.3%）至少有一张未配药处方。男性未配药处方的占比低于女性（12.9%对13.5%；OR：0.95；CI：0.95 - 0.95）。与最年轻年龄组相比，年龄较大组未配药处方的占比更低。未配药药物占比最低的是抗肿瘤和免疫调节药物（7.8%）以及心血管系统药物（8.1%），而最高的是皮肤科药物（20.2%）。未配药处方的比例在不同药物组之间有所不同，从甲状腺治疗药物的5%到其他神经系统药物的38%。最常未配药的药物是对乙酰氨基酚、布洛芬和沙丁胺醇。
未配药处方的占比和数量在治疗领域、药物组、活性药物成分和患者群体中各不相同。医疗保健专业人员应避免不必要的开药，并提高药物治疗依从性，以确保更安全、更有效的护理。
