title: "My doctor has changed my pills without telling me": impact of generic medication switches in stroke survivors.
abstract: Generic (i.e. non-branded medicine) and therapeutic (i.e. a less expensive drug from the same class) substitution of medication provides considerable financial savings, but may negatively impact on patients. We report secondary qualitative/quantitative analysis of stroke survivors from a pilot randomised controlled brief intervention to increase adherence to medication. Patients' experiences of medication changes were examined in conjunction with electronically-recorded medication adherence. Twenty-eight patients reported frequent medication changes (e.g. size/shape/colour/packaging) and two-thirds of these reported negative effects, resulting in, at least, confusion and, at worst, mistakes in medication-taking. Patients reporting a direct effect on their medication-taking (n = 6) demonstrated poorer objectively-measured adherence (i.e. % doses taken on schedule) than those reporting confusion [mean difference = 19.9, 95% CI (2.0, 37.8)] or no problems [mean difference = 20.6, 95% CI (1.6, 40.0)]. Changes to medication resulting from switching between generic brands can be associated with notable problems, including poorer medication adherence, for a significant minority.
authors: Division of Psychology, School of Natural Sciences, University of Stirling, Stirling, FK9 4LA, Scotland, UK, j.a.chambers@stir.ac.uk.
authors: Julie A
authors: JA
authors: Chambers
authors: Ronan E
authors: RE
authors: O'Carroll
authors: Martin
authors: M
authors: Dennis
authors: Cathie
authors: C
authors: Sudlow
authors: Marie
authors: M
authors: Johnston
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057915:Drug Substitution / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D020521:Stroke / Q000188:drug therapy / Q000523:psychology*; D017741:Survivors / Q000523:psychology; D016903:Drug Monitoring