Patient responsiveness in chronic non-communicable diseases therapy in General practice according to e-health database

Vija Silina, Jelena Danilenko

Keywords: Non-communicable diseases, prescriptions, patient responsiveness

Background:

On the 1st of January, 2018 mandatory use of e-Health in Latvian health care has been started. Previously, it was difficult to keep track of whether a patient always uses a prescription drug from a pharmacy

Research questions:

Do patients with most common chronic non-communicable diseases regularly take the prescribed medications from pharmacy to ensure appropriate treatment

Method:

A cross sectional survey was carried out in the general practice (GP) in Riga. Prescriptions (from 01/18/18 till 28/02/19) for the most common chronic conditions in the practice of a GP were selected: primary arterial hypertension (PAH), diabetes mellitus type 2 (DM 2), bronchial asthma (BA), and chronic obstructive pulmonary disease COPD). There were reviewed and classified as used or not used (data from pharmacies). The Mann-Whitney test was used for comparison. Data are described using median, interquartile range (IQR), R-Spearman's rank correlation coefficients.

Results:

In total 4697 state compensated prescriptions have been written out, 95 of them were recalled. In total 4602 active prescriptions were analyzed. In total 3.59% of prescriptions were not used.
• From 3874 prescriptions for PAH, 133 (3.4%) were not used. Patients age median is 68 (IQR - 21).
• From 495 prescriptions for DM 2 13 (2.6%) were not used, Patients age median is 69 (IQR - 13).
• From 288 prescriptions for BA 19 (6.6%) were not used. Patients age median is 45 (IQR - 50).
• From 288 prescriptions for COPD, all were used.
• Women don’t use prescriptions more often than men (p = 0.47).
• There was a weak positive but statistically significant correlation between the number of didn’t used prescriptions with patient age (r = 0.097, p = 0.001).

Conclusions:

About 4% of patients do not use the prescriptions for chronic conditions in the GP practice. Women more often than men don’t use the prescribed therapy.

Points for discussion:

E-health system provides statistical information about whether patients have bought the prescribed medications and can be used for quality improvement in the GP practice.

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