Medication use patterns and health outcomes among patients using a subsidized prescription drug program.
OBJECTIVE
To evaluate medication adherence, medication safety, health care utilization, and health outcomes among patients enrolled in a subsidized prescription program.


METHODS
Cross-sectional study.


METHODS
Conducted as part of the Prescription Access program, a subsidized prescription program serving indigent patients residing in Franklin County, Ohio.


METHODS
Patients qualifying for enrollment in the program were uninsured and had a household income of 200% or less of federal poverty level. Approximately 5% of the 2,500 patients (mean age, 70.6 years) enrolled in the program were systematically selected from a computer-generated patient enrollment report.


METHODS
Telephone interviews conducted by a pharmacist or advanced student pharmacist between January and September 2002.


METHODS
Patterns of medication use and safety, level of health care utilization, and health outcomes.


RESULTS
A total of 104 patients reported taking a mean (+/- SD) of 6.7 +/- 3.8 medications. A total of 72 (69%) patients reported taking their medications correctly, and 90 (87%) reported finishing their medication course as prescribed. Medication refills were obtained by 75 (72%) patients, but of these patients, only 55 (73%) indicated that they obtained their refills on time. Adverse effects occurred in 25 (24%) patients, and 2 patients reported an allergic reaction. A total of 51 (49%) patients made unscheduled visits to their primary care physician, another health care facility, an emergency department, and/or were admitted to a hospital. Unscheduled visits occurred more often among nonadherent patients (59%) than adherent patients (44%), but not significantly so. In addition, 82 (79%) patients reported an improvement in health-related quality of life (QOL); 90 (87%) had a means of transportation to obtain medications; and 93 (89%) indicated that they would have to skip medications or give up necessities, if they were not enrolled in a subsidized prescription program.


CONCLUSIONS
An improvement in self-reported QOL and a high rate of medication adherence demonstrate support for the benefits of this and similar subsidized prescription drug programs. A high rate of additional health care utilization, especially among nonadherent patients, indicates an area for further analysis, program revisions, and/or patient education.
Spiker
Erin C
EC
Medical Affairs, Amgen Inc., One Amgen Center Drive, Mail Stop: 27-1-D, Thousand Oaks, CA 91320, USA. espiker@amgen.com
Giannamore
Martin R
MR
Nahata
Milap C
MC
D000368:Aged; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D008297:Male; D006278:Medicare; D009820:Ohio; D017063:Outcome Assessment, Health Care