Risk factors for medication non-adherence among Victorian patients receiving Home Medicine Reviews (HMRs)

Mr Kyrillos Guirguis1

1PharmaceuCare, Tarneit, Australia

Abstract:

Aim:
To identify risk factors that predict non-adherence among patients receiving HMRs.

Method:
Retrospective study of 109 patients who received HMRs in 2014/2015. Patients’ medication lists and HMR reports were reviewed for comments on non-adherence to medications. Factors considered as possible predictors of non-adherence were age, gender, CALD status, number of drugs, number of medical conditions, number of Over the Counter (OTC) products, number of complimentary & alternative medicines (CAM), availability of carers/family support, the use of pillboxes, patients’ need for education on their medicines, CHF, diabetes, pain, respiratory conditions and dyslipidaemia. Multiple logistic regression analysis was conducted, and a model developed to identify the most significant predictors.

Results:
The regression model (p<0.00001) demonstrated that three factors were related to patients’ non-adherence. Respiratory conditions inferred a five-fold increase in the risk of non-adherence, while the use of OTC products was associated with a two-fold increase. The odds of non-adherence were almost threefold among male patients.

Significance:
Medication non-adherence is a major cause of morbidity and hospitalisation. Outreach allied health clinicians could screen patients with identified risk factors and refer them to receive HMR services, which improve compliance to medications and optimise health outcomes. This supports patients in the community, before medication-related problems worsen and hospital visits become unavoidable. Furthermore, the referral criteria for HMRs should be re-evaluated, to accurately define patient cohorts that would benefit the most from the service and improve its economic sustainability.

Biography:

Kyrillos is a practising consultant pharmacist with extensive clinical experience. He is the Principal Consultant Pharmacist at PharmaceuCare, and Manager, Performance & Quality at MCCC GP Training. He is affiliated with the School of Medicine (UTAS) as a casual academic. Kyrillos has valuable research experience, having managed various research projects that led to publications in international peer-reviewed journals. He is a reviewer for Patient Education & Counselling and the American Journal of Health-System Pharmacy. He has years of experience in education, and has published two books: Successful Online Study and Community to Hospital Pharmacy: making the transition! to support pharmacists’ professional development and career progression. Kyrillos is ultimately passionate about the quality use of medicines, aiming to optimise health outcomes for patients with chronic disease.