The data regarding filling of prescriptions for cardiovascular drugs (?=adherence to treatment) in this report was based on analysis of PBS data related to health care card holders (because for them all the drugs are below the PBS threshold), not from BEACH data which cannot provide data on patient adherence.
Graeme Miller On 28 May 2007 at 16:15, Ken Harvey wrote: > I'd be interested in people's comments on this report? > ---------------------------------------------------------------------- > > Heart meds: half patients don't comply > > http://www.pharmainfocus.com.au/news.asp?newsid=1732 > > Posted 28 May 2007 > > A vast problem with cardiovascular medicines compliance in Australia has > been confirmed by the latest research from the Australian Institute of > Health and Welfare (AIHW). > > A report released last week, "Medicines for cardiovascular health: are > they used appropriately?" examines how medicines for cholesterol > reduction, hypertension and ischaemic heart disease are being prescribed > by GPs and used by patients. > > Susana Senes of the Institute's Cardiovascular Disease and Diabetes > Unit, said 10% to 25% of patients had discontinued their medicines six > months after starting treatment, and this rose to 21% to 47% 24 months > after first being prescribed medication. > > "Overall, the results of our study indicate a high level of > discontinuation of medicines that are generally intended to be taken > long-term. This represents a significant waste of resources and a lost > opportunity to prevent cardiovascular disease with medicines known to be > effective," the study report said. > > The statistical study was based on BEACH data from 2000 to 2006 and > found that persistence - continuing to take prescribed medications - and > compliance - taking them at the correct frequency and dose - both > declined after patients were initially prescribed. > > In particular it revealed that one in six patients (17%) had > discontinued statins at six months from the start of therapy. This > figure exceeded one in three after 24 months (35%). "In the first 12 > months of therapy, 77% of newly prescribed patients were assessed as > compliant with statins, that is, they had sufficient medicine to use it > at the prescribed frequency and dose," the report said. > > The picture was somewhat better for angiotensin II receptor antagonists > and ACE inhibitors with 88-91% of patients persisting with treatment > after six months. After 24 months 75-79% were still taking the > medicines. The higher figures were for combination products. > > Eighty-seven percent of newly prescribed patients were assessed as > compliant with ACE inhibitors or plain angiotensin II antagonists, and > 89% were compliant with angiotensin II antagonists combinations. > > Three quarters of beta-blocker patients continued filling their > prescriptions at six months but by 24 months this had dropped to almost > half. > > The same survey found that over 365,000 patients only ever received one > script for a cardiovascular medication resulting, it said, in a minimum > cost to government and patients of $7.4 million which was effectively > wasted. > > Although the AIHW said it did not have access to patient information > that would allow it to explore why patients were stopping their > medications, "The fact that for the most part our analyses were confined > to concessional patients, for whom out-of-pocket expenses on medicines > would be relatively low, suggests that cost does not play a big role". > > It quoted other research showing that factors associated with poor > concordance (persistence and compliance) include the treatment of a > condition with no symptoms (such as high blood pressure and high blood > cholesterol), the presence of depression, inadequate follow-up or > discharge planning, side effects, poor communication between health > professional and patient, patient´s lack of understanding of their > condition, patient´s lack of belief in the benefit of treatment, > complexity of treatment, missing doctor´s appointments and cost. > _______________________________________________ > Gpcg_talk mailing list > [email protected] > http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk ********************************** Associate Professor Graeme Miller MB BS PhD FRACGP Medical Director Family Medicine Research Centre (A Collaborating Centre of the World Organisation of Family Doctors) University of Sydney Level 7 16-18 Wentworth St Parramatta NSW Mail: Westmead Hospital Westmead NSW 2145 Australia Medical Director Australian General Practice Statistics and Classification Centre Australian Institute of Health and Welfare/ University of Sydney Phone +61 2 9845 8156 Mobile 0412 465 585 Fax +61 2 9845 8155 Skype name: graymil Email [EMAIL PROTECTED] Web http://www.fmrc.org.au *********************************************************************** This e-mail, including any attachments sent with it, is confidential and for the sole use of the intended recipient(s). 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