title: Norwegian patients on generic antihypertensive drugs: a qualitative study of their own experiences.
abstract: OBJECTIVE
  The aim of this study was to investigate experiences with and attitudes toward generic substitution in patients on antihypertensive medication.
  
  
  METHODS
  Study participants were 22 patients from pharmacies in Oslo who had taken brand antihypertensive products as well as substituted generic products. Five focus- group discussions were held.
  
  
  RESULTS
  Only a few participants claimed to take their medications as prescribed. Most reported low drug adherence before and after generic substitution. Fourteen said that their blood pressure was not under control. Most patients did not know what it meant to get a generic product. They normally accepted what the pharmacy offered, even if they thought the generics were of a lower quality than the brand products. Five participants experienced new side effects. Differences in name, color, form, or taste caused confusion. The patients had been told in the pharmacy that the effect of a generic product was as good as that of the brand product but were still confused, as in most cases the doctor said nothing to them about the substitution.
  
  
  CONCLUSIONS
  Generic substitution works well in Norway as an economic health strategy, but drug adherence remains suboptimal under those circumstances. Patients are insecure with respect to the difference between the old and the new product when it comes to the drug's physical attributes and perceived quality. Patients would feel safer if the doctor had a more active role in informing them about the system.
authors.affiliation: Department of Social Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway. e.l.toverud@farmasi.uio.no
authors.forename: Else-Lydia
authors.initials: EL
authors.lastname: Toverud
authors.forename: Anne Kjersti
authors.initials: AK
authors.lastname: Røise
authors.forename: Grete
authors.initials: G
authors.lastname: Hogstad
authors.forename: Inger
authors.initials: I
authors.lastname: Wabø
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics* / Q000627:therapeutic use; D001294:Attitude to Health; D057915:Drug Substitution; D016568:Drugs, Generic / Q000191:economics* / Q000627:therapeutic use; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009664:Norway; D010045:Outpatients; D010594:Pharmacies; D010595:Pharmacists; D010820:Physicians; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013810:Therapeutic Equivalency
chemical_list: D000959:Antihypertensive Agents; D016568:Drugs, Generic