Current Prescription-medicine News Results

Community pharmacy dispensing of prescription medicine sample packs: changing the business of medicine initiation?

J Eval Clin Pract. 2010 Jul 29;
Kyle GJ, Nissen L, Tett S

Pharmacists' and consumers' viewpoints on counselling on prescription medicines in Australian community pharmacies.

Int J Pharm Pract. 2010 Aug; 18(4): 202-8
Puspitasari HP, Aslani P, Krass I

OBJECTIVE: The aim was to investigate and compare counselling on prescription medicine provided by Australian community pharmacists based on pharmacist and consumer self-reports, and to explore consumers' interest in receiving prescription medicine information. METHODS: Mail and face-to-face surveys containing comparable questions for both study groups. The setting was Sydney metropolitan community pharmacies, Australia (22 pharmacists and 157 consumers). KEY FINDINGS: No statistically significant differences were found between pharmacists and consumers in reporting provision of verbal information for new (Z = -0.57, P = 0.57) and repeat prescriptions (Z = -1.71, P = 0.09). However, there were statistically significant differences between the two cohorts in reporting dissemination of written information (Z = -2.6, P = 0.009 and Z = -2.68, P = 0.007 for new and repeat prescriptions, respectively). Both groups reported that the most common type of verbal information provided by pharmacists was in relation to medicine administration rather than safety aspects of medicines. Approximately 59% of consumers expressed an interest in receiving counselling for new prescriptions only. CONCLUSIONS: Pharmacists regularly provided verbal counselling on new prescription medicines, but infrequently provided written medicine information or any type of information for regular medicines. Lack of consumers' interest in receiving prescription medicine information may have contributed to the low counselling rates. Thus, there is a need to develop strategies to improve pharmacist counselling practice and to enhance consumer involvement in the counselling process.

Medicine-taking practices in community-dwelling people aged > or =75 years in New Zealand.

Age Ageing. 2010 Sep; 39(5): 574-80
Tordoff JM, Bagge ML, Gray AR, Campbell AJ, Norris PT

BACKGROUND: older people experience more chronic medical conditions than younger people, take more prescription medicines and are more likely to suffer from cognitive or memory problems. Older people are more susceptible to the adverse effects of medicines, which may reduce their quality of life or lead to hospitalisation or death. OBJECTIVE: this study aims to identify medicine-taking practices amongst community-dwelling people aged > or =75 years in New Zealand. METHODS: this study was carried out in an urban setting in Dunedin (population 120,000), New Zealand. Interviews of a random sample of people from the electoral roll using a structured questionnaire were conducted. Subjects were community-dwelling people aged > or =75 years taking one or more prescription medicines. From a random sample of 810 people extracted from the electoral roll intended to recruit 300 participants, 524 people met the study criteria and were invited to participate. People living in a rest home or hospital, not contactable by telephone, or now deceased, were excluded. Responses were analysed, medicines categorised by the Anatomical Therapeutic Chemical classification and adherence classed as high, medium and low using a modified four-item Morisky Medication Adherence Scale. Univariate and multivariate linear and logistic regression was applied to combinations of variables. RESULTS: in total, 316 interviews were undertaken; a 61% response rate. Participants were 75-79 (35%), 80-84 (40%) and >85 years (25%); New Zealand European/European (84%), 'New Zealanders' (14%) or Maori (2%); and 141 (45%) lived alone. Almost half (49%) regularly saw a specialist and a third (34%) had been admitted to hospital in the past 12 months. Participants used a median of seven prescription medicines (range 1-19) and one non-prescription medicine (0-14). The majority (58%) believed medicines are effective and had systems/routines (92%) for remembering to take them. Doses tended to be missed following a change in routine, e.g. holiday. Men were more likely to report 'trouble remembering' than women (odds ratio = 1.86, 95% confidence interval 1.10-3.14; P = 0.020). Seventy-five percent of people had high or medium adherence scores and 25%, low scores. Common problems were reading and understanding labels (9 and 4%, respectively) and leaflets (12%, 6%), and difficulty swallowing solid dose forms (14%). Only 6% had problems paying for their medicines. Around 17% wanted to know more about their medicines, and some people were confused about their medicines following hospital discharge. CONCLUSION: overall, community-dwelling people aged > or =75 years in this study appeared to manage their medicines well and found them affordable. Nevertheless, there is a need to improve labelling, leaflets and education on medicines, particularly at hospital discharge.

Marvelous medicines and dangerous drugs: the representation of prescription medicine in the UK newsprint media.

Public Underst Sci. 2010 Jan; 19(1): 52-69
Prosser H

Using discourse analysis, this study examines the representation of prescription medicines in the UK newsprint media and, specifically, how the meaning and function of medicines are constructed. At the same time, it examines the extent to which the newsprint media represents a resource for health information, and considers how it may encourage or challenge faith in modern medicine and medical authority. As such, it extends analysis around concepts such as the informed patient and examines the representation of patients and doctors and the extent to which patient-doctor identities promoted in the newsprint media reflect a shift away from paternalism to negotiated encounters. Findings show the media constructs a discrete, contradictory, and frequently oversimplified set of characterizations about medicine. Moreover, it discursively constructs realities that justify and sustain medial dominance. Ideological paradigms in discourse assign patients as passive and disempowered while simultaneously privileging "expert" knowledge. This constructs a reality that marginalizes patients' participation in decision-making.

Ingestion of six cylindrical and four button batteries.

Clin Toxicol (Phila). 2010 Jun; 48(5): 469-70
Nielsen SU, Rasmussen M, Hoegberg LC

We report a suicidal ingestion of six cylindrical and four button batteries, in combination with overdosed prescription medicine and smoking of cannabis.

Antimicrobial use in Danish pig herds with and without postweaning multisystemic wasting syndrome.

Prev Vet Med. 2010 Jul 1; 95(3-4): 239-47
Jensen VF, Enøe C, Wachmann H, Nielsen EO

A retrospective cohort study was performed on 130 pig herds in Denmark, to assess the effect of PMWS on the use of antimicrobial drug. The study comprised 65 herds diagnosed with PMWS during 2003-2004, and matched by the veterinary practitioner with 65 herds free from PMWS. Information on antimicrobial use 1 year before and 1 year after the diagnosis was achieved from the National Prescription Medicine Monitoring Database, VetStat, and summarized on quarter within age group and herd. The multiple linear regression analysis comprised antimicrobial use as the outcome variable with (1) quarter relative to diagnosis of PMWS in the positive herd (same date for the negative match), (2) diagnosis of PMWS (same date used for matched PMWS(-) herd), (3) season and (4) temporal trend as fixed effects. Relative to the unaffected herds, the antimicrobial use in the sow units in the PMWS(+) herds was elevated significantly by 35% in the last quarter and 43% in the fourth quarter before positive diagnosis in the herds (p<0.05). In weaner pigs, the antimicrobial use increased significantly two quarters before, and one quarter after the positive diagnosis, by 68%, 91% and 124% respectively. In weaner pigs, effects were seen of herd size and season. The study support that increased morbidity occur for an extended period prior to the diagnosis of PMWS, both in the sow units and the weaner pig units and further indicate that the syndrome cease after the diagnosis, with a decrease in need for antimicrobial treatment.

Influence of culture and discrimination on care-seeking behavior of elderly African Americans: a qualitative study.

Soc Work Public Health. 2010 May; 25(3): 311-26
Martin SS, Trask J, Peterson T, Martin BC, Baldwin J, Knapp M

In this study, the influence of culture and discrimination on care-seeking behavior of elderly African Americans was explored. This was a qualitative phenomenological study that involved in-depth interviews with 15 African American men and women aged 60 and older in Alabama. The sample size of 15 was adequate for the phenomenological method of this study. While this was a small exploratory study and was not intended for any generalizations, it did provide a unique opportunity to hear the voices, the concerns, and the stories of elderly African Americans, which have often been overlooked in the literature. The following themes emerged from the analysis of data: (1) perception of health as ability to be active, (2) reluctance toward prescription medicine use, (3) lack of trust in doctors, (4) avoidance of bad news, (5) race of doctors, (6) use of home remedies, and (7) importance of God and spirituality on health, illness, and healing.

An examination of Alzheimer's disease case definitions using Medicare claims and survey data.

Alzheimers Dement. 2010 Jul; 6(4): 334-41
Lin PJ, Kaufer DI, Maciejewski ML, Ganguly R, Paul JE, Biddle AK

BACKGROUND: The prevalence and expenditure estimates of Alzheimer's disease (AD) from studies using one data source to define cases vary widely. The objectives of this study were to assess agreement between AD case definitions classified with Medicare claims and survey data and to provide insight into causes of widely varied expenditure estimates. METHODS: Data were obtained from the 1999-2004 Medicare Current Beneficiary Survey linked with Medicare claims (n = 57,669). Individuals with AD were identified by survey, diagnosis, use of an AD prescription medicine, or some combination thereof. We also explored how much health care and drug expenditures vary by AD case definition. RESULTS: The prevalence of AD differed significantly by case definition. Using survey report alone yielded more cases (n = 1,994 or 3.46%) than diagnosis codes alone (n = 1,589 or 2.76%) or Alzheimer's medication use alone (n = 1,160 or 2.01%). Agreement between case definitions was low, with kappa coefficients ranging from 0.37 to 0.40. Per capita health expenditures ranged from $16,547 to $24,937, and drug expenditures ranged from $2,303 to $3,519, depending on how AD was defined. CONCLUSIONS: Different information sources yield widely varied prevalence and expenditure estimates. Although claims data provided a more objective means for identifying AD cases, survey report identified more cases, and pharmacy data also are an important source for case ascertainment. Using any single source will underestimate the prevalence and associated cost of AD. The wide range of AD cases identified by using different data sources demands caution interpreting cost-of-illness studies using single data sources.

Prescription drug coverage among elderly and disabled Americans: can Medicare-Part D reduce inequities in access?

Int J Health Care Finance Econ. 2010 Sep; 10(3): 203-18
Kanavos P, Gemmill-Toyama M

This paper explores the determinants of demand for prescription drug coverage among the elderly population in the United States, using data from the Medical Expenditure Panel Survey (MEPS) and seeks to analyse the impact that the Medicare prescription drug coverage bill (Medicare-Part D) has on Medicare beneficiaries. The results indicate that individuals who are Hispanic, black, or of another race or ethnicity, over the age of 74, not married, in poor health, fall into the low- to middle-income brackets, and have less than a high school degree are more likely to be covered through a public program, more likely to be uninsured for prescription medicine outlays, and less likely to have private prescription drug coverage. The paper concludes that there is cause for considerable concern for low income citizens who have significant prescription drug outlays, and, therefore, the greatest need because their prescription drug costs may not be covered beyond a certain limit unless they reach catastrophic proportions. This continues to raise equity in access concerns among elderly patients.

The prevalence of herbs use in conjunction with conventional medicines in Jamaica.

Complement Ther Med. 2010 Feb; 18(1): 13-20
Delgoda R, Younger N, Barrett C, Braithwaite J, Davis D

Due to the global rise in the popularity of herbal medicines, adversities resulting from concomitant use of both prescription drugs and herbs are becoming an increasingly important public health issue. OBJECTIVES: To estimate the prevalence of the use of herbal medicines among persons on prescription medicines in Jamaica. Findings are thought to aid in estimates of the risk of adversities from drug-herb interactions through laboratory investigations and to provide awareness among policy makers responsible for the design of appropriate pharmacovigilance systems in the country. METHODS: A survey was conducted in eighteen pharmacies throughout Jamaica and patients or parents/carers of children who were on at least one prescription medicine were administered a structured questionnaire by trained interviewers. RESULTS: Of 399 persons invited to participate in the study 365 (91.5% response rate) agreed to do so and were included in the study. This study population consisted of 306 adults and 60 children and of that 243 adults (80.6%) and 45 children (75.6%) engaged in the concomitant use of herbs and drugs. Patients with a variety of disease conditions, in both rural and urban environs engaged in concomitant herb-drug use. Persons with higher salary (P<0.1) and those with health insurance (P<0.02) tended to have a lower prevalence of herb-drug concomitant use. Among persons indicating such practices the most commonly cited reason for concurrent use of prescription medicine and herbal preparations was the belief that there was no harm in taking both (269, 94.0%) followed by the belief that the prescription medicine alone was not adequate cure (211, 71%). Only 55 (18%) respondents who practised such co-medication indicated that their doctors knew of their use of herbal preparations. CONCLUSION: There is a high prevalence of herb-drug concomitant use in Jamaica, and an awareness within the medical community and those monitoring adversities would serve well to mitigate risks from potential drug-herb interactions.

Safety of non-prescription medicines: knowledge and attitudes of Italian pharmacy customers.

Pharm World Sci. 2010 Feb; 32(1): 97-102
Cuzzolin L, Benoni G

OBJECTIVE: A survey was designed to investigate customers attitudes and knowledge toward non-prescription medicines taken on a self-medication basis but not devoid of risks. SETTING: Community pharmacies in Italy. METHOD: Forty-four pharmacies participated in the project. On the basis of an anonymous questionnaire, face-to-face interviews were made to customers buying a non-prescription medicine over a 2-month period. The questionnaire included information about socio-demographic characteristics of the interviewed subjects and 18 items designed to elicit information about the kind of medicine purchased and reason of use, general product knowledge in relation to quality and risks, attitudes toward this kind of drugs, concurrent prescription drug use and the quality of relationship with the pharmacist. RESULTS: During the study period, 613 interviews were collected. The most frequently non-prescription medicines purchased by customers were non-steroidal anti-inflammatory drugs, paracetamol and medicines for gastrointestinal problems. The most of interviewees referred to read carefully the package inserts or to ask information to pharmacists. Moreover, they reported to consider non-prescription medicines easy to manage and to be used only for minor ailments and for short periods. 55.3% of customers reported to have been taking at least a prescription drug, mostly antihypertensives or other cardiovascular medicines, in association with non-prescription medicines. In this situation, interviewees often did not inform pharmacists about chronic therapies. CONCLUSION: Our interviews demonstrate that, in general, Italian customers have a cautious approach toward non-prescription medicines and are informed on their use. However, in case of a long-term use, interviewees underestimate risks related to possible physiological/pathological changes in their organism or to interactions with other drugs.

Association of hypertension treatment and control with all-cause and cardiovascular disease mortality among US adults with hypertension.

Am J Hypertens. 2010 Jan; 23(1): 38-45
Gu Q, Dillon CF, Burt VL, Gillum RF

BACKGROUND: Clinical trials have provided convincing evidence that blood pressure (BP) lowering treatment reduces the risk of cardiovascular disease (CVD) and total mortality. The objective of this study was to examine the association of hypertension treatment, control, and BP indexes with all-cause and cardiovascular mortality among US adults with hypertension. METHODS: Persons aged > or =18 years from the Third National Health and Nutrition Examination Survey (NHANES III) were identified as hypertensives based on a BP > or =140/90 mm Hg or current treatment for hypertension. Vital status in 2006 was ascertained by passive follow-up using the National Death Index. Cox regression models were used to assess correlates of survival. RESULTS: At baseline, 52% of hypertensive adults reported currently taking prescription medicine for high BP and 38% of treated persons had BP controlled. Compared to treated controlled hypertensives, treated uncontrolled hypertensives had a 1.57-fold (95% confidence interval (CI) 1.28-1.91) and 1.74-fold (95% CI 1.36-2.22) risk of all-cause and cardiovascular mortality; untreated hypertensives had a 1.34-fold (95% CI 1.12-1.62) and 1.37-fold (95% CI 1.04-1.81) risk of all-cause and cardiovascular mortality, respectively. The association persisted after further excluding persons with pre-existing hypertension comorbidities. Mortality risk was linearly increased with systolic BP (SBP), pulse pressure (PP), and mean arterial pressure (MBP), whereas diastolic BP (DBP) was not a significant predictor of cardiovascular mortality overall. No significant associations were observed between drug classes and mortality risk. CONCLUSIONS: This study indicates that uncontrolled and untreated hypertension was associated with increased risk of total and cardiovascular mortality among the general hypertensive population.

Medication effects on midtrimester maternal serum screening.

Am J Obstet Gynecol. 2009 Dec; 201(6): 622.e1-5
Pekarek DM, Chapman VR, Neely CL, Ramsey PS, Biggio JR

OBJECTIVE: To determine whether medication classes are associated with alterations in concentrations of Quad screen analytes or the screen-positive rate. STUDY DESIGN: We conducted a retrospective cohort study of women with singleton gestations who received prenatal care and had a Quad screen performed in the University of Alabama at Birmingham system. Information on prescription medications was abstracted. Mean multiples of the medians for each analyte (alpha-fetoprotein, estriol, human chorionic gonadotropin, and inhibin A) and overall screening results were compared between those taking the class of medication and controls not taking any medications. RESULTS: There were 6206 women evaluated; 1337 took at least 1 prescription medicine and 4869 were controls. Mean analyte multiples of the medians were significantly different in women taking some medications compared with controls. Women taking certain medications had an increased screen-positive rate. CONCLUSION: Medications taken around the time of maternal serum screening are associated with alterations in individual analyte multiples of the medians, as well as the screen-positive rates.

Antacid use and reduced bioavailability of oral drugs. Case studies, overview and perspectives.

Arzneimittelforschung. 2009; 59(7): 327-34
Srinivas NR

A close scrutiny of deployment of the present day home medicines has shown increased indulgence of antacids as a household remedy. While such household interventions are considered innocuous, it could trigger potential drug-drug interaction(s), if the subject is taking other prescription medicine(s). Examination of the literature indicated that co-administration of antacids may have the potential to cause therapy failures due to reduced oral bioavailability of several drugs. Additionally, fortified foods and beverages with mineral supplement may also have the potential to reduce the bioavailability of oral drugs. On the basis of this review a number of drugs displayed reduced oral bioavailability in the presence of antacids. However, almost one third of the reviewed drugs showed a drastic bioavailability reduction (< 50%) warranting total avoidance of antacid ingestion in such drug uses. If antacid use is warranted, it needs to be carefully monitored in relation to the administration of the drug (either pre or post drug administration). It appeared that a safe window for antacid administration could be established especially for drugs that display moderate reduction of oral bioavailability. While possible mechanisms explaining the purported antacid-drug interaction are covered, additional perspectives with regard to assessment protocols for antacid-drug interaction are discussed.

[Herpes zoster incidence in persons above 50 years of age]

Ugeskr Laeger. 2009 Jun 22; 171(26): 2194-7
Østergaard K, Damgaard M, Kristiansen TB, Kristensen TB, Madsen KG

INTRODUCTION: Following the development of herpes zoster vaccines and the potential socio-economic benefits hereof, it is relevant to conduct a study concerning epidemiological aspects of the disease based on a Danish population. MATERIAL AND METHODS: Structured telephone interviews with 1207 persons above 50 years of age were conducted in order to determine the cumulated incidence proportion of herpes zoster in the age groups 50-66 years, 66-70 years and 71+. RESULTS: The cumulated incidence proportion of herpes zoster was 8.9%, 12.5%, 16.0% in the age groups 50-65 years, 65-70 years and 71+, respectively. Herpes zoster was positively associated with female sex, hypertension, hypercholesterolemia and prescription medicine; however, only the former remained significant after test in a multiple logistic regression model. CONCLUSION: Herpes zoster is common among persons who are more than 50 years old and most frequent among women.

The impact of information on patient preferences in different delivery patterns: a contingent valuation study of prescription versus OTC drugs.

Health Policy. 2009 Dec; 93(2-3): 102-10
Lamiraud K, von Bremen K, Donaldson C

OBJECTIVES: Our analysis assessed the impact of information on patients' preferences in prescription versus over-the-counter (OTC) delivery systems. METHODS: A contingent valuation (CV) study was implemented, randomly assigning 534 lay people into the receipt of limited or extended information concerning new influenza drugs. In each information arm, people answered two questions: the first asked about willingness to pay (WTP) for the new prescription drug; the second asked about WTP for the same drug sold OTC. RESULTS: We show that WTP is higher for the OTC scenario and that the level of information plays a significant role in the evaluation of the OTC scenario, with more information being associated with an increase in the WTP. In contrast, the level of information provided has no impact on WTP for prescription medicine. Thus, for the kind of drug considered here (i.e. safe, not requiring medical supervision), a switch to OTC status can be expected to be all the more beneficial, as the patient is provided with more information concerning the capability of the drug. CONCLUSIONS: Our results shed light on one of the most challenging issues that health policy makers are currently faced with, namely the threat of a bird flu pandemic. Drug delivery is a critical component of pandemic influenza preparedness. Furthermore, the congruence of our results with the agency and demand theories provides an important test of the validity of using WTP based on CV methods.

The male-female health-survival paradox: a survey and register study of the impact of sex-specific selection and information bias.

Ann Epidemiol. 2009 Jul; 19(7): 504-11
Oksuzyan A, Petersen I, Stovring H, Bingley P, Vaupel JW, Christensen K

PURPOSE: This study examined whether the health-survival paradox could be due partially to sex-specific selection and information bias in surveys. METHODS: The study is based on the linkage of three population-based surveys of 15,330 Danes aged 46-102 years with health registers covering the total Danish population regarding hospitalizations within the last 2 years and prescription medicine within 6 months before the baseline surveys. RESULTS: Men had higher participation rates than women at all ages. Hospitalized women and women taking medications had higher participation rate compared with nonhospitalized women (difference=0.7%-3.0%) and female nonusers (difference=0.8%-7.6%), respectively, whereas no consistent pattern was found among men according to hospitalization or medication use status. Men used fewer medications than women, but they underreported medication use to a similar degree as did women. CONCLUSIONS: Hospitalized women, as well as women using prescription medicine, were slightly overrepresented in the surveys. Hence, the study found some evidence that selection bias in surveys may contribute to the explanation of the health-survival paradox, but its contribution is likely to be small. However, there was no evidence for sex-specific reporting of medication use among study participants.

Whom do older adults trust most to provide information about prescription drugs?

Am J Geriatr Pharmacother. 2009 Apr; 7(2): 105-16
Donohue JM, Huskamp HA, Wilson IB, Weissman J

BACKGROUND: Cost-related nonadherence to medieations is common among older adults, yet physician-patient communication about medication cost concerns is infrequent. One factor affecting communication and adherence may be older adults' confidence in the information about prescription drugs provided by physicians and other sources. OBJECTIVES: This study was conducted to identify which source older adults most trust to provide information on drugs and to examine the relationship between older patients' trust in physicians to provide price information and the occurrence of cost-related nonadherence. METHODS: We conducted a cross-sectional national telephone survey of individuals aged > or =50 years who were taking at least 1 prescription medication. Respondents were asked how much they would trust various sources (physician, pharmacist, nurse, insurance plan, the Internet, consumer groups, friends and family) to provide helpful information on "the price of the prescription medicine compared to others like it" and on "how well the prescription medicine will work for you compared to other medicines like it." The response options were a lot, somewhat, and not at all. Other measures of interest were respondents' beliefs concerning physicians' ability to lower drug costs and patient activation. We also evaluated the potential association between trust in physicians to deliver drug price information and cost-related medication nonadherence. RESULTS: Compared with the other sources of information studied, doctors and pharmacists were the sources that respondents were most likely to trust "a lot" to provide information on drug prices (55.6% and 61.7%, respectively) and to provide information on drug effectiveness (79.9% and 66.4%). Less than half (42.3%) of respondents who said that they trusted their doctor to provide drug price information "somewhat" or "not at all" agreed that there are ways doctors could lower drug costs (P = 0.01 vs those who trusted their doctor "a lot"). Adults aged > or =65 years were more likely than those aged 50 to 64 years to trust their doctors "a lot" to provide information on drug prices (odds ratio [OR] = 1.44; 95% CI, 1.08-1.92); the same was true of members of minority groups compared with white respondents (OR = 1.72; 95%) CT, 1.1 3-2.61 ). Among individuals with high drug spending, those who placed "a lot" of trust in their doctors to provide price information were less likely than those who trusted their doctor "somewhat" or "not at all" to have cost-related nonadhcrence (OR = 0.40; 95% CI, 0.20-0.78). CONCLUSIONS: In this survey, older adults trusted physicians and pharmacists more than the other sources studied to provide information on prescription drugs. Trust in physicians to provide price information was an important moderator of the effect of high drug spending on cost-related nonadhcrence. Efforts to provide patients and their providers with comparative data on drug prices and effectiveness may reduce cost-related nonadhcrence.

Striving for quality use of medicines: how effective is Australia's ban on direct-to-consumer prescription medicine advertising?

J Law Med. 2009 Feb; 16(4): 666-83
Brown S

The potential for both positive and negative effects arising from direct-to-consumer advertising of prescription medicines challenges health policymakers to develop regulatory schemes which selectively capture the positive aspects of the practice. Australia has dealt with this quandary by banning the practice, while New Zealand and the United States permit it. However, in recent times pharmaceutical companies have been increasingly successful in introducing promotional materials into the Australian market. This article demonstrates that the Australian ban is consistent with striving for the major policy goal of quality use of medicines, thus providing the basis for arguing that solutions to strengthen the ban against the identified threats ought to be implemented. Quality use of medicines can be most effectively achieved via the combined effect of the strengthened ban and the mimicking of the limited positive aspects of direct-to-consumer advertising by government provision of non-promotional information to consumers.

[Suitability of the Personal Electronic Medication profile for estimation of medication compliance]

Ugeskr Laeger. 2009 Mar 9; 171(11): 899-903
Andersen LS, Kjeldsen LJ, Haugbølle LS

INTRODUCTION: Denmark operates a so-called personal electronic medication record (PEM) containing information about prescription medicine purchased by patients. This study examined the PEM compliance module in order to determine its suitability for evaluating patient compliance. MATERIAL AND METHODS: We collected data from 256 patients who participated in an intervention project conducted on Funen among users of antihypertensive medication. Data were collected from patient information in PEM. The data were used to compare three types of compliance which were all based on information in PEM: 1) calculating compliance, 2) compliance chart, 3) DDD (defined daily doses) chart. RESULTS: The 256 patients used a total of 1,062 medications (1-13 medications per person). It was not possible to calculate compliance for 240 (23%) medications distributed on 141 patients (55%). Compliance was highest for method 1 and lowest for method 3; conversely, non-compliance was lowest for method 1 and highest for method 3. Combining the three revealed a considerable discrepancy (44-66%) in the assessment of patient compliance. CONCLUSION: The PEMs lacked information for approx. 1/5 of the medications; consequently it was not possible to calculate compliance for these persons. The results indicate that for compliance assessment, PEM quality is less than optimal.