4th RQRM ANNUAL MEETING “NEW CHALLENGES IN DRUG RESEARCH”

Abstract

Introduction:

In the province of Quebec, all prescription drugs dispensed in pharmacy are entered in patient records. As pharmacists have access to individual patient’s record, they can monitor therapies. Thus, patients who use only one pharmacy are likely to receive better treatment than others.

Objectives:

Among individuals newly treated with oral antidiabetes drugs ( AD), to assess the effect of pharmacy loyalty on adherence to AD and on the use of guidelines - recommended drugs: 1) ACE inhibitor (ACEi) or angiotensin receptor blocker (ARB); 2) lipid-lowering drug.

Methods:

Using Quebec administrative databases we carried out a cohort study of individuals aged ? 18 years who had started an oral AD between 2000 and 2006 and had ? 2 years of follow - up. Individuals who had filled all their prescriptions in the same pharmacy during the 1st year after oral AD initiation were considered loyal. Adherence to AD treatment (persistence and proportion of days covered ? 80%) and use of an ACEi/ARB and of a lipid - lowering drug were measured in the 2nd year. Outcomes were assessed using multivariate logistic regressions.

Results:

Among 124,009 eligible individuals, 59.8% were loyal to their pharmacy, 80.8% were persistent with their AD, 78.2% of persisters were compliant with their AD, 64.1% used an ACEI/ARB and 63.7% used a lipid-lowering drug. Loyal individuals were more likely to be persistent (Odds Ratio: 1.13; 95% CI: 1.09 - 1. 16), to be compliant with their AD (1.22; 1.19 - 1.26), to use an ACEI/ARB (1.17; 1.14 - 1.20) and to use a lipid-lowering drug (1.21; 1.18 - 1.24).

Conclusion:

Pharmacy loyalty is associated with a better quality of AD use. It suggests that pharmacists can better play their role in optimizing their clients ’ drug use for patients loyal to their pharmacy as they can then rely on recorded drug use information that is comprehensive.