title: Community pharmacy loyalty among individuals with schizophrenia.
abstract: BACKGROUND
  Community pharmacists can use medication records to assist individuals who are loyal to their pharmacy in better managing their pharmacotherapy. However, the extent of community pharmacy loyalty among individuals with severe mental illness such as schizophrenia remains unknown.
  
  
  OBJECTIVE
  To assess the extent of community pharmacy loyalty among individuals with schizophrenia and identify factors associated with loyalty.
  
  
  METHODS
  Using the Quebec Health Insurance Board databases, a cohort study of individuals with schizophrenia who claimed an antipsychotic drug for the first time between January 1, 2001 and December 31, 2005 was conducted. Such individuals were considered loyal to their community pharmacy if they filled all their prescriptions for any drug at the same community pharmacy during the second year after antipsychotics initiation. Logistic regression models were used to identify factors associated with community pharmacy loyalty (measured in the first year after antipsychotics initiation).
  
  
  RESULTS
  Of the 6159 individuals in the study, 57.8% were loyal to one pharmacy. Men were more likely to be loyal (Adjusted OR = 1.29; 95% CI = 1.16-1.44), as were individuals aged 30-64 years and those aged ≥65 years, when compared to individuals 20-29 years (1.70; 1.48-1.95 and 2.39; 1.97-2.90, respectively). Individuals who filled their antipsychotics on a weekly basis were also more likely to be loyal (1.39; 1.18-1.63). Factors associated with non-loyalty were welfare beneficiary status (0.79; 0.70-0.89), having substance-use disorder (0.69; 0.60-0.80), a greater number of different types of drugs (5-8 types = 0.76; 0.66-0.87; 9-51 = 0.59; 0.50-0.69), and emergency department visits (0.71; 0.60-0.82).
  
  
  CONCLUSIONS
  Results suggest that medication records in community pharmacies are incomplete for 42.2% of individuals with schizophrenia. Individuals more likely to experience more severe illness were also those less likely to be loyal. Given the potentially severe consequences of medication-related problems in this latter population, strategies to further improve the comprehensiveness of medication information should be promoted.
authors.affiliation: Faculty of Pharmacy, 1050 avenue de la Médecine, Université Laval, Québec, QC, Canada G1V 0A6; Chair on adherence to treatments, Université Laval, Québec, QC, Canada G1V 0A6; Santé des populations: URESP, Centre de recherche du CHU de Québec, 1050 Chemin Ste-Foy, Québec, QC, Canada G1S 4L8. Electronic address: sophie.lauzier@pha.ulaval.ca.
authors.forename: Sophie
authors.initials: S
authors.lastname: Lauzier
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Grégoire
authors.forename: Alain
authors.initials: A
authors.lastname: Lesage
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Moisan
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003157:Community Pharmacy Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011792:Quebec; D012559:Schizophrenia / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotics; Community pharmacy; Community pharmacy services; Pharmaceutical services; Pharmacy; Schizophrenia