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International Journal of Clinical Pharmacy

, Volume 37, Issue 4, pp 626–635 | Cite as

Primary non-adherence in Portugal: findings and implications

  • Filipa Alves da CostaEmail author
  • Ana Rita Pedro
  • Inês Teixeira
  • Fátima Bragança
  • José Aranda da Silva
  • José Cabrita
Research Article

Abstract

Background Portugal is currently facing a serious economic and financial crisis, which is dictating some important changes in the health care sector. Some of these measures may potentially influence patients’ access to medication and consequently adherence, which will ultimately impact on health status, especially in chronic patients. Aims This study aimed at providing a snapshot of adherence in patients with chronic conditions in Portugal between March and April 2012. Setting Community pharmacy in Portugal. Method A cross-sectional pilot study was undertaken, where patients were recruited via community pharmacies to a questionnaire study evaluating the number of prescribed and purchased drugs and, when these figures were inconsistent, the reasons for this. Main outcome measures Primary and secondary adherence measures. Failing to purchase prescription items was categorized as primary nonadherence. Secondary nonadherence was attributed to purchasing prescription items, but not taking medicines as prescribed. Results Data were collected from 375 patients. Primary nonadherence was identified in 22.8 % of patients. Regardless of the underlying condition, the most commonly reported reason for primary non-adherence was having spare medicines at home (“leftovers”), followed by financial problems. The latter appeared to be related to the class of medicines prescribed. Primary non-adherence was associated with low income (<475 €/month; p = 0.026). Secondary non-adherence, assessed by the 7-MMAS was detected in over 50 % of all patients, where unintentional nonadherence was higher than intentional nonadherence across all disease conditions. Conclusion This study revealed that more than one fifth of chronic medication users report primary nonadherence (22.8 %) and more than 50 % report secondary nonadherence. Data indicates that the existence of spare medicines and financial constraints occurred were the two most frequent reasons cited for nonadherence (47, 6–64, 8 and 19–45.5 %, depending on the major underlying condition, respectively).

Keywords

Diabetes Hyperlipidemia Hypertension Medication adherence Portugal 

Notes

Funding

None.

Conflicts of interest

All authors are part of the Portuguese Observatory of Health Systems (OPSS), which is an independent body that annually develops research looking at the impact of political measures taken on the health sector. Research is conducted independently of their academic institutions and is evaluated by peers from other institutions in order to ensure unbiased results are published. For all the above reasons, the authors declare there are no conflicts of interests to be declared. More information about the OPSS can be obtained at http://www.observaport.org/.

Supplementary material

11096_2015_108_MOESM1_ESM.pdf (38 kb)
Supplementary material 1 (PDF 38 kb)

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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015

Authors and Affiliations

  • Filipa Alves da Costa
    • 1
    Email author
  • Ana Rita Pedro
    • 2
  • Inês Teixeira
    • 3
  • Fátima Bragança
    • 2
  • José Aranda da Silva
    • 4
  • José Cabrita
    • 5
  1. 1.Instituto Superior de Ciências da Saúde Egas Moniz, Centro de Investigação Interdisciplinar Egas MonizObservatório Português dos Sistemas de SaúdeCaparicaPortugal
  2. 2.Escola Nacional de Saúde Pública, Grupo de Investigação em Políticas e Administração de SaúdeObservatório Português dos Sistemas de SaúdeLisbonPortugal
  3. 3.Centre for Health Evaluation and Research (CEFAR), Contract Research Organization (CRO), Grupo/Group Associação Nacional das Farmácias (ANF)Observatório Português dos Sistemas de SaúdeLisbonPortugal
  4. 4.FormifarmaObservatório Português dos Sistemas de SaúdeEstorilPortugal
  5. 5.Faculdade de Farmácia, Sub-grupo de Sócio-farmáciaUniversidade de Lisboa, Observatório Português dos Sistemas de SaúdeLisbonPortugal

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