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Physicians’ and pharmacies’ overview of patients’ medication. An analysis of fidelity coefficients

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

An Erratum to this article was published on 10 November 2011

An Erratum to this article was published on 10 November 2011

Abstract

Background

It is essential that pharmacies and prescribers have an overview of each patient’s medication in order to prevent drug interactions, unintentional co-prescribing, unnecessary polypharmacy and underprescribing. We have assessed this overview by measuring the ‘fidelity coefficient’, a measure of the extent to which a drug user has a preference for one prescriber or one pharmacy.

Methods and setting

Data for all prescriptions issued for the population in Southern Denmark (population 1.2 million) in 2009 was extracted from the Odense University Pharmacoepidemiological Database (OPED). Analysis of the extracted data was then limited to persons with at least ten prescriptions within the year, resulting in 8,246,064 prescriptions issued to 283,388 individuals. For each individual, we identified the most used prescriber and calculated the proportion of all prescriptions accounted for by that prescriber (FCpresc). The individual user’s most frequented pharmacy was also identified and the FCpharm calculated in a similar fashion.

Results

The average FCPresc and average FCPharm were 0.883 (standard deviation 0.158) and 0.927 (0.139), respectively. The estimated difference was 0.0446 (95% confidence interval 0.0439–0.0453). Among the factors associated with a high FCpresc and high FCpharm were older age, male gender and a high volume of prescriptions. The major drug classes that were most often prescribed by a non-main prescriber were beta-lactams, antidepressants and opioids. Similarly, the major drug classes associated with use of non-main pharmacy were beta-lactams, antidepressants and inhaled beta-agonists.

Conclusion

Based on this analysis, both prescribers and pharmacies generally have an equal potential for maintaining an excellent overview of their patients’ medication, but the pharmacies account for a slightly higher proportion of patients.

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References

  1. Madsen HK, Hallas J (2009) Udvikling I lægemiddelforbruget I Danmark (in Danish). Ugeskr Laeger 171(19):775–777

    PubMed  Google Scholar 

  2. Department of Health (2004). Prescriptions dispensed in the community: statistics for 1993–2003. London, Department of Health. Available at: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4094068.pdf

  3. Barat I, Andreasen F, Damsgaard EMS (2000) The consumption of drugs by 75-year-old individuals living in their own homes. Eur J Clin Pharmacol 56:501–509

    Article  PubMed  CAS  Google Scholar 

  4. Glintborg B, Poulsen HE, Dalhof KP (2007) The use of nationwide on-line prescription records improves the drug history in hospitalized patients. Br J Pharmacol 65(2):265–269

    Google Scholar 

  5. Foss S, Schmidt JR, Andersen T, Rasmussen JJ, Damsgaard J, Schaefer K, Munck LK (2004) Congruence on medication between patients and physicians involved in patient course. Eur J Clin Pharmacol 59:841–847

    Article  PubMed  CAS  Google Scholar 

  6. Glintborg B, Andersen SK, Poulsen HE (2009) Prescription data improve the medication history in primary care. Qual Saf Health Care 19(3):164–168

    Article  Google Scholar 

  7. Torrible SJ, Hogan DB (1997) Medication use and rural seniors - who really knows that whey are taking? Can Fam Physician 43:893–898

    PubMed  CAS  Google Scholar 

  8. Warholak TL, McCulloch M, Baumgart A, Smith M, Fink W, Fritz W (2009) An exploratory comparison of medication lists at hospital admission with administrative database records. J Manag Care Pharm 15(9):751–758

    PubMed  Google Scholar 

  9. Tulner LR, Kuper IMJA, Frankfort SV, van Campen JPCM, Koks CHW, Brandjes DPM, Beijnen JH (2009) Discrepancies in reported drug use in geriatric outpatients: relevance to adverse events and drug-drug interactions. Am J Geriatr Pharmacother 7(2):93–104

    Article  PubMed  Google Scholar 

  10. Gilchrist WJ, Lee YC, Tam HC, MacDonald JB, Williams BO (1987) Prospective study of drug reporting by general practitioners for an elderly population referred to a geriatric service. Br Med J 294:289–290

    Article  CAS  Google Scholar 

  11. Tamblyn RM, McLeod PJ, Abrahamowicz M, Laprise R (1996) Do to many cooks spoil the broth? Multiple physician involvement in medical management of elderly patients and potentially inappropriate drug combinations. Can Med Assoc J 154(8):1177–1184

    CAS  Google Scholar 

  12. Green JL, Hawley JN, Rask KJ (2007) Is the number of prescribing physicians an independent risk factor for adverse drug events in an elderly outpatient population? Am J Geriatr Pharmacother 5(1):31–39

    Article  PubMed  Google Scholar 

  13. Gaist D, Sørensen HT, Hallas J (1997) The Danish prescription registries. Dan Med Bull 44(4):445–448

    PubMed  CAS  Google Scholar 

  14. Hallas J, Dall M, Andries A, Andersen BS, Aalykke C, Hansen JM, Andersen M, Lassen AT (2006) Use of single and combined antithrombotic therapy and risk of serious upper gastrointestinal bleeding: population based case-control study. Br Med J 333(7571):726–730

    Article  Google Scholar 

  15. Bereznicki BJ, Peterson GM, Jackson SL, Walters EH, Fitzmaurice KD, Gee PR (2008) Data-mining of medication records to improve asthma management. Med J Aust 189(1):21–25

    PubMed  Google Scholar 

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Correspondence to Jesper Hallas.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00228-011-1155-8

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Pottegård, A., Hallas, J. Physicians’ and pharmacies’ overview of patients’ medication. An analysis of fidelity coefficients. Eur J Clin Pharmacol 67, 919–924 (2011). https://doi.org/10.1007/s00228-011-1026-3

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