Refill Adherence in Relation to Substitution and the Use of Multiple Medications: A Nationwide Population Based Study on New ACE-Inhibitor Users

Bjerkeli, Pernilla J. (author): Lund University,Lunds universitet,Socialepidemiologi,Forskargrupper vid Lunds universitet,Social Epidemiology,Lund University Research Groups,Nordic School of Public Health, Gothenburg, Sweden / Unit for Social Epidemiology, Clinical Research Centre, Faculty of Medicine, Lund University, Lund, Sweden

Jonsson, A. K. (author): Swedish National Board of Forensic Medicine, Lund,Department of Forensic Genetics and Forensic Toxicology, National Board Forensic Medicine, Linköping, Sweden

Mårdby, Ann-Charlotte, 1976 (author): University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Research and Development, Sahlgrenska University Hospital, Gothenburg, Sweden / Section for Epidemiology and Social Medicine, Department of Public Health and Community Medicine at Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

Andersson Sundell, Karolina, 1978 (author): University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Section for Epidemiology and Social Medicine, Department of Public Health and Community Medicine at Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

(creator_code:org_t)

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Abstract Subject headings

Objective Generic substitution has contributed to economic savings but switching products may affect patient adherence, particularly among those using multiple medications. The aim was to analyse if use of multiple medications influenced the association between switching products and refill adherence to angiotensin-converting-enzyme (ACE) inhibitors in Sweden. New users of ACE-inhibitors, starting between 1 July 2006 and 30 June 2007, were identified in the Swedish Prescribed Drug Register. Refill adherence was assessed using the continuous measure of medication acquisition (CMA) and analysed with linear regression and analysis of covariance. The study population included 42735 individuals whereof 51.2% were exposed to switching ACE-inhibitor and 39.6% used multiple medications. Refill adherence was higher among those exposed to switching products than those not, but did not vary depending on the use of multiple medications or among those not. Refill adherence varied with age, educational level, household income, country of birth, previous hospitalisation and previous cardiovascular diagnosis. The results indicate a positive association between refill adherence and switching products, mainly due to generic substitution, among new users of ACE-inhibitors in Sweden. This association was independent of use of multiple medications.

MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmaceutiska vetenskaper (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmaceutical Sciences (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences (hsv//eng)

By the author/editor: Bjerkeli, Pernil ...; Jonsson, A. K.; Lesén, Eva, 1982; Mårdby, Ann-Char ...; Andersson Sundel ...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Basic Medicine; and Pharmaceutical S ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Health Care Serv ...

By the university: University of Gothenburg; Lund University; University of Skövde

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