More than a quarter of new prescriptions are unfilled, especially when the drugs are for symptomless conditions, researchers from Boston's Brigham and Women's Hospital have found. Physicians have long been concerned that many patients fill new prescriptions one time, then never get refills. But it has been impossible in the past to determine adherence to new prescriptions. The new study was made possible by the implementation of an electronic-prescribing initiative by two Massachusetts health plans.
Dr. Michael A. Fischer of Brigham and Women's and his colleagues studied 75,589 patients treated by 1,217 physicians in the first year of the e-prescribing initiative, comparing prescriptions to requests for reimbursement. They reported in the February Journal of General Internal Medicine that 151,837 of 195,930 prescriptions (78%) were filled. Of 82,245 prescriptions for new medications, 58,984 were filled (72%).
Prescriptions written for children had the highest adherence, with 87% being filled. But only 71.6% of medications for hypertension, 71.8% of those for high cholesterol and 68.6% of those for diabetes were filled.
The researchers were not able to explore why the prescriptions went unfilled. Some possible reasons included lack of insurance and the high cost of the drugs, high co-payments, worry over potential side effects, and the desire to avoid new drugs. Patients with high blood pressure, high cholesterol and diabetes may also not see the need for the drugs when they do not have symptoms, especially when cost is a factor, Fischer said.
Also, added Jeff Stier of the American Council on Science and Health, "There's a belief out there that unless you actually feel sick, you should not be taking medication. It's almost as if it is a virtue not to take medication. This should be a wake-up call."
-- Thomas H. Maugh II