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Gomez-Cano M, Wiering B, Abel G, et al. Medication adherence and clinical outcomes in dispensing and non-dispensing practices: a cross-sectional analysis. Br J Gen Pract. 2020;71(702):e55-e61doi: 10.3399/bjgp20X713861.
Gomez-Cano, M., Wiering, B., Abel, G., Campbell, J. L., & Clark, C. E. (2021). Medication adherence and clinical outcomes in dispensing and non-dispensing practices: a cross-sectional analysis. The British journal of general practice : the journal of the Royal College of General Practitioners, 71(702), e55-e61. https://doi.org/10.3399/bjgp20X713861
Gomez-Cano, Mayam, et al. "Medication adherence and clinical outcomes in dispensing and non-dispensing practices: a cross-sectional analysis." The British journal of general practice : the journal of the Royal College of General Practitioners vol. 71,702 (2021): e55-e61. doi: https://doi.org/10.3399/bjgp20X713861
Gomez-Cano M, Wiering B, Abel G, Campbell JL, Clark CE. Medication adherence and clinical outcomes in dispensing and non-dispensing practices: a cross-sectional analysis. Br J Gen Pract. 2020 Dec 28;71(702):e55-e61. doi: 10.3399/bjgp20X713861. Print 2021 Jan. PMID: 33257460; PMCID: PMC7716871.
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Br J Gen Pract. 2020 Dec 28;71(702):e55-e61. doi: 10.3399/bjgp20X713861. Print 2021 Jan.

Medication adherence and clinical outcomes in dispensing and non-dispensing practices: a cross-sectional analysis.

The British journal of general practice : the journal of the Royal College of General Practitioners

Mayam Gomez-Cano, Bianca Wiering, Gary Abel, John L Campbell, Christopher E Clark

Affiliations

  1. Primary Care Research Group, Institute of Health Services Research, University of Exeter Medical School, Exeter.

PMID: 33257460 PMCID: PMC7716871 DOI: 10.3399/bjgp20X713861

Abstract

BACKGROUND: Most patients obtain medications from pharmacies by prescription, but rural general practices can dispense medications. The clinical implications of this difference in drug delivery are unknown. This study hypothesised that dispensing status may be associated with better medication adherence. This could impact intermediate clinical outcomes dependent on medication adherence in, for example, hypertension or diabetes.

AIM: To investigate whether dispensing status is associated with differences in achievement of Quality and Outcomes Framework (QOF) indicators that rely on medication adherence.

DESIGN AND SETTING: Cross-sectional analysis of QOF data for 7392 general practices in England.

METHOD: QOF data from 1 April 2016 to 31 March 2017 linked to dispensing status for general practices with list sizes ≥1000 in England were analysed. QOF indicators were categorised according to whether their achievement depended on a record of prescribing only, medication adherence, or neither. Differences were estimated between dispensing and non-dispensing practices using mixed-effects logistic regression, adjusting for practice population age, sex, deprivation, list size, single-handed status, and rurality.

RESULTS: Data existed for 7392 practices; 1014 (13.7%) could dispense. Achievement was better in dispensing practices than in non-dispensing practices for seven of nine QOF indicators dependent on adherence, including blood pressure targets. Only one of ten indicators dependent on prescribing but not adherence displayed better achievement; indicators unrelated to prescribing showed a trend towards higher achievement by dispensing practices.

CONCLUSION: Dispensing practices may achieve better clinical outcomes than prescribing practices. Further work is required to explore underlying mechanisms for these observations and to directly study medication adherence rates.

© The Authors.

Keywords: diabetes mellitus; hypertension; medication adherence; primary health care; quality indicators; therapeutic adherence and compliance

References

  1. Patient Educ Couns. 2000 May;40(2):173-85 - PubMed
  2. PLoS One. 2018 Mar 6;13(3):e0193952 - PubMed
  3. J Am Pharm Assoc (2003). 2009 Sep-Oct;49(5):e132-46; quiz e147-9 - PubMed
  4. J Behav Med. 2009 Jun;32(3):278-84 - PubMed
  5. J Epidemiol Community Health. 2006 Nov;60(11):917-22 - PubMed
  6. N Engl J Med. 2018 Sep 06;379(10):948-957 - PubMed
  7. J Community Health. 2013 Oct;38(5):976-93 - PubMed
  8. J Epidemiol Community Health. 2001 Jan;55(1):44-51 - PubMed
  9. Arch Intern Med. 2003 Jan 13;163(1):83-90 - PubMed
  10. BMJ Open. 2018 Jun 28;8(6):e021161 - PubMed
  11. Curr Med Res Opin. 2010 Mar;26(3):683-705 - PubMed
  12. J Psychosom Res. 2008 Jan;64(1):47-54 - PubMed
  13. Biomed Res Int. 2014;2014:658056 - PubMed
  14. Prim Health Care Res Dev. 2016 Jan;17(1):42-55 - PubMed
  15. BMJ Open. 2012 May 14;2(3): - PubMed
  16. Aust New Zealand Health Policy. 2006 Jun 26;3:8 - PubMed
  17. Patient Educ Couns. 2009 Oct;77(1):60-7 - PubMed
  18. Br J Gen Pract. 2017 Sep;67(662):e650-e658 - PubMed
  19. J Clin Pharm Ther. 1996 Oct;21(5):343-8 - PubMed
  20. Br J Gen Pract. 2017 May;67(658):e306-e313 - PubMed
  21. Br J Gen Pract. 2018 Oct;68(675):e735-e742 - PubMed
  22. BMJ. 2006 Feb 18;332(7538):389-90 - PubMed
  23. BMJ Open. 2016 Nov 24;6(11):e013059 - PubMed
  24. Qual Saf Health Care. 2007 Dec;16(6):446-9 - PubMed
  25. BMJ. 1993 May 8;306(6887):1244-6 - PubMed
  26. Eur J Clin Pharmacol. 2012 Oct;68(10):1365-73 - PubMed
  27. J Psychosom Res. 1999 Dec;47(6):555-67 - PubMed
  28. BMJ Open. 2019 Feb 5;9(2):e026886 - PubMed
  29. Health Policy. 2009 Sep;92(1):1-9 - PubMed
  30. Br J Gen Pract. 2018 Aug;68(673):e541-e550 - PubMed
  31. BMJ Open. 2015 Feb 18;5(2):e006261 - PubMed
  32. BMC Fam Pract. 2019 Feb 8;20(1):26 - PubMed
  33. J Am Pharm Assoc (Wash). 2002 May-Jun;42(3):497-507 - PubMed
  34. J Manag Care Spec Pharm. 2016 Nov;22(11):1330-1336 - PubMed
  35. BMJ. 1993 Oct 2;307(6908):846-8 - PubMed

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