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Refill adherence in relation to substitution and the use of multiple medications : A nationwide population based study on new ACE-inhibitor users

Bjerkeli, Pernilla J. LU ; Jönsson, Anna K.; Lesén, Eva; Mårdby, Ann Charlotte and Sundell, Karolina Andersson (2016) In PLoS One 11(5).
Abstract

Objective: Generic substitution has contributed to economic savings but switching products may affect patient adherence, particularly among those using multiple medications. The aim was to analyse if use of multiple medications influenced the association between switching products and refill adherence to angiotensin-converting-enzyme (ACE) inhibitors in Sweden. Study Design and Setting: New users of ACE-inhibitors, starting between 1 July 2006 and 30 June 2007, were identified in the Swedish Prescribed Drug Register. Refill adherence was assessed using the continuous measure of medication acquisition (CMA) and analysed with linear regression and analysis of covariance. Results: The study population included 42735 individuals whereof... (More)

Objective: Generic substitution has contributed to economic savings but switching products may affect patient adherence, particularly among those using multiple medications. The aim was to analyse if use of multiple medications influenced the association between switching products and refill adherence to angiotensin-converting-enzyme (ACE) inhibitors in Sweden. Study Design and Setting: New users of ACE-inhibitors, starting between 1 July 2006 and 30 June 2007, were identified in the Swedish Prescribed Drug Register. Refill adherence was assessed using the continuous measure of medication acquisition (CMA) and analysed with linear regression and analysis of covariance. Results: The study population included 42735 individuals whereof 51.2% were exposed to switching ACE-inhibitor and 39.6% used multiple medications. Refill adherence was higher among those exposed to switching products than those not, but did not vary depending on the use of multiple medications or among those not. Refill adherence varied with age, educational level, household income, country of birth, previous hospitalisation and previous cardiovascular diagnosis. Conclusion: The results indicate a positive association between refill adherence and switching products, mainly due to generic substitution, among new users of ACE-inhibitors in Sweden. This association was independent of use of multiple medications.

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author
organization
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Contribution to journal
publication status
published
subject
in
PLoS One
volume
11
issue
5
publisher
Public Library of Science
external identifiers
  • Scopus:84971425317
ISSN
1932-6203
DOI
10.1371/journal.pone.0155465
language
English
LU publication?
yes
id
de0d088d-4fad-483d-860d-8c8458e45911
date added to LUP
2016-06-14 11:29:24
date last changed
2016-07-06 14:27:08
@misc{de0d088d-4fad-483d-860d-8c8458e45911,
  abstract     = {<p>Objective: Generic substitution has contributed to economic savings but switching products may affect patient adherence, particularly among those using multiple medications. The aim was to analyse if use of multiple medications influenced the association between switching products and refill adherence to angiotensin-converting-enzyme (ACE) inhibitors in Sweden. Study Design and Setting: New users of ACE-inhibitors, starting between 1 July 2006 and 30 June 2007, were identified in the Swedish Prescribed Drug Register. Refill adherence was assessed using the continuous measure of medication acquisition (CMA) and analysed with linear regression and analysis of covariance. Results: The study population included 42735 individuals whereof 51.2% were exposed to switching ACE-inhibitor and 39.6% used multiple medications. Refill adherence was higher among those exposed to switching products than those not, but did not vary depending on the use of multiple medications or among those not. Refill adherence varied with age, educational level, household income, country of birth, previous hospitalisation and previous cardiovascular diagnosis. Conclusion: The results indicate a positive association between refill adherence and switching products, mainly due to generic substitution, among new users of ACE-inhibitors in Sweden. This association was independent of use of multiple medications.</p>},
  author       = {Bjerkeli, Pernilla J. and Jönsson, Anna K. and Lesén, Eva and Mårdby, Ann Charlotte and Sundell, Karolina Andersson},
  issn         = {1932-6203},
  language     = {eng},
  number       = {5},
  publisher    = {ARRAY(0xa69a8b8)},
  series       = {PLoS One},
  title        = {Refill adherence in relation to substitution and the use of multiple medications : A nationwide population based study on new ACE-inhibitor users},
  url          = {http://dx.doi.org/10.1371/journal.pone.0155465},
  volume       = {11},
  year         = {2016},
}