One in 3 prescriptions are never redeemed: Primary nonadherence in an outpatient clinic

Background Despite being essential to medication adherence, redemption of initial prescriptions (ie, primary adherence) has been investigated only sparsely. Objectives The objectives were to determine the frequency and risk factors for primary nonadherence among outpatients with dermatologic conditions. Methods Every 15th day during 2006, all patients receiving a prescription for an initial treatment with a previously untried medication were studied. Redemptions were traced in an electronic register after 4 weeks. Exclusions were a result of identical treatments within the last 6 months or hospitalizations within 4 weeks. Results In all, 30.7% of the 322 eligible patients did not collect their medication. Patients with psoriasis were least adherent with nearly 50% of the prescriptions being unredeemed. Limitations Only initial prescriptions for previously untried medications issued to hospital outpatients were studied. Conclusions For the clinician, primary nonadherence is an essential differential diagnosis when a given therapy fails.