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首页> 外文期刊>Patient Preference and Adherence >Pharmacist-led medication non-adherence intervention: reducing the economic burden placed on the Australian health care system
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Pharmacist-led medication non-adherence intervention: reducing the economic burden placed on the Australian health care system

机译：药剂师主导的药物非依从性干预：减轻澳大利亚医疗体系的经济负担

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Background: Scarcity of prospective medication non-adherence cost measurements for the Australian population with no directly measured estimates makes determining the burden medication non-adherence places on the Australian health care system difficult. This study aims to indirectly estimate the national cost of medication non-adherence in Australia comparing the cost prior to and following a community pharmacy-led intervention. Methods: Retrospective observational study. A de-identified database of dispensing data from 20,335 patients (n=11,257 on rosuvastatin, n=6,797 on irbesartan and n=2,281 on desvenlafaxine) was analyzed and average adherence rate determined through calculation of PDC. Included patients received a pharmacist-led medication adherence intervention and had twelve months dispensing records; six months before and six months after the intervention. The national cost estimate of medication non-adherence in hypertension, dyslipidemia and depression pre- and post-intervention was determined through utilization of disease prevalence and comorbidity, non-adherence rates and per patient disease-specific adherence-related costs. Results: The total national cost of medication non-adherence across three prevalent conditions, hypertension, dyslipidemia and depression was $10.4 billion equating to $517 per adult. Following enrollment in the pharmacist-led intervention medication non-adherence costs per adult decreased $95 saving the Australian health care system and patients $1.9 billion annually. Conclusion: In the absence of a directly measured national cost of medication non-adherence, this estimate demonstrates that pharmacists are ideally placed to improve patient adherence and reduce financial burden placed on the health care system due to non-adherence. Funding of medication adherence programs should be considered by policy and decision makers to ease the current burden and improve patient health outcomes moving forward.
机译：背景：缺乏直接测量的估计值的澳大利亚人群前瞻性药物非依从性成本测量的缺乏使得确定澳大利亚医疗体系中药物非依从性的负担位置变得困难。这项研究旨在通过比较社区药房主导的干预前后的费用，间接估算澳大利亚不服药的国家费用。方法：回顾性观察研究。分析了来自20335名患者（罗苏伐他汀组n = 11,257，厄贝沙坦组n = 6,797，去甲文拉法辛组n = 2,281）的分配数据的身份不明数据库，并通过计算PDC确定了平均依从率。纳入的患者接受了药剂师指导的药物依从性干预，并有十二个月的配药记录;干预前六个月和干预后六个月。通过利用疾病患病率和合并症，不依从率以及每位患者特定疾病的依从性相关费用，确定了干预前和后对高血压，血脂异常和抑郁症药物不依从性的国家成本估算。结果：在三种普遍的情况下，高血压，血脂异常和抑郁症，全国不服药的总费用为104亿美元，相当于每个成年人517美元。加入药剂师主导的干预药物后，每个成年人的非依从性费用降低了95澳元，从而为澳大利亚的医疗体系和患者每年节省了19亿澳元。结论：在没有可直接衡量的国家不服药成本的情况下，该估计值表明，药剂师的理想位置是改善患者的依从性，并减少因不遵从而给卫生保健系统带来的经济负担。政策和决策者应考虑药物依从性计划的资金，以减轻当前的负担并改善患者的健康状况。

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