Cost-related medication nonadherence in Canada: a systematic review of prevalence, predictors, and clinical impact
| العنوان: | Cost-related medication nonadherence in Canada: a systematic review of prevalence, predictors, and clinical impact |
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| المؤلفون: | Angela Ford, Mei Wang, Michael Cristian Garcia, Selina Manji, Munil Lee, Laura Nguyen, Zhiyuan Chen, Anne Holbrook, Michael R. Law |
| المصدر: | Systematic Reviews, Vol 10, Iss 1, Pp 1-13 (2021) Systematic Reviews |
| بيانات النشر: | BMC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Canada, Younger age, Population, MEDLINE, Medicine (miscellaneous), Medication adherence, lcsh:Medicine, Cochrane Library, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, medicine, Prevalence, Humans, 030212 general & internal medicine, education, Sampling frame, Randomized Controlled Trials as Topic, education.field_of_study, business.industry, 030503 health policy & services, Research, lcsh:R, Insurance, Pharmaceutical Services, Medication costs, Family medicine, Medication Nonadherence, Systematic review, Health Expenditures, 0305 other medical science, business |
| الوصف: | Background Cost-related nonadherence to medications (CRNA) is common in many countries and thought to be associated with adverse outcomes. The characteristics of CRNA in Canada, with its patchwork coverage of increasingly expensive medications, are unclear. Objectives Our objective in this systematic review was to summarize the literature evaluating CRNA in Canada in three domains: prevalence, predictors, and effect on clinical outcomes. Methods We searched MEDLINE, Embase, Google Scholar, and the Cochrane Library from 1992 to December 2019 using search terms covering medication adherence, costs, and Canada. Eligible studies, without restriction on design, had to have original data on at least one of the three domains specifically for Canadian participants. Articles were identified and reviewed in duplicate. Risk of bias was assessed using design-specific tools. Results Twenty-six studies of varying quality (n = 483,065 Canadians) were eligible for inclusion. Sixteen studies reported on the overall prevalence of CRNA, with population-based estimates ranging from 5.1 to 10.2%. Factors predicting CRNA included high out-of-pocket spending, low income or financial flexibility, lack of drug insurance, younger age, and poorer health. A single randomized trial of free essential medications with free delivery in Ontario improved adherence but did not find any change in clinical outcomes at 1 year. Conclusion CRNA affects many Canadians. The estimated percentage depends on the sampling frame, the main predictors tend to be financial, and its association with clinical outcomes in Canada remains unproven. |
| اللغة: | English |
| تدمد: | 2046-4053 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::890450bd6b5c7d1af10bbf75712b0aa6 https://doaj.org/article/539e9cf2ccba4e9b9a369b958397f328 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....890450bd6b5c7d1af10bbf75712b0aa6 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 20464053 |
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