Prospective analysis of the medicine possession ratio of antidepressants in the private health sector of South Africa, 2006 - 2011
Major depressive disorder (MDD) is a disabling mental illness with high morbidity and mortality rates. Inadequate treatment efficacy, unfavourable side-effect profiles and consequent shortfalls in compliance are major stumbling blocks in its treatment. Non-compliance data in low- to middle-income co...
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| Veröffentlicht in: | SAMJ: South African Medical Journal 2015-02, Vol.105 (2), p.139-144 |
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| creator | Slabbert, Francois Naude Harvey, Brian H Brink, Christiaan Beyers Lubbe, Martha Susanne |
| description | Major depressive disorder (MDD) is a disabling mental illness with high morbidity and mortality rates. Inadequate treatment efficacy, unfavourable side-effect profiles and consequent shortfalls in compliance are major stumbling blocks in its treatment. Non-compliance data in low- to middle-income countries are lacking.
To investigate the prevalence of antidepressant (AD) non-compliance in the private healthcare sector of South Africa (SA).
We conducted a prospective cohort study analysing AD medicine claims (N=35 175) for 14 135 patients, obtained from a nationally representative pharmaceutical benefit management company, over a 6-year study period (1 January 2006 - 31 December 2011). The medicine possession ratio (MPR) was used as a proxy to determine compliance with AD medication. Only patients >18 years of age whose treatment had been initiated by a psychiatrist following an appropriate International Classification of Diseases (10th edition) (ICD-10) diagnosis of a mood disorder were included. A patient was considered compliant if the MPR was between ≥80% and ≤110% over a >4-month treatment period.
After the first 4 months, only 34% of patients were compliant. A statistically significant association was found between active ingredient consumed and compliance (p |
| doi_str_mv | 10.7196/samj.8394 |
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To investigate the prevalence of antidepressant (AD) non-compliance in the private healthcare sector of South Africa (SA).
We conducted a prospective cohort study analysing AD medicine claims (N=35 175) for 14 135 patients, obtained from a nationally representative pharmaceutical benefit management company, over a 6-year study period (1 January 2006 - 31 December 2011). The medicine possession ratio (MPR) was used as a proxy to determine compliance with AD medication. Only patients >18 years of age whose treatment had been initiated by a psychiatrist following an appropriate International Classification of Diseases (10th edition) (ICD-10) diagnosis of a mood disorder were included. A patient was considered compliant if the MPR was between ≥80% and ≤110% over a >4-month treatment period.
After the first 4 months, only 34% of patients were compliant. A statistically significant association was found between active ingredient consumed and compliance (p<0.0001). Only 26.2% of patients who received amitriptyline-containing products were compliant, compared with 38.8% and 38.7% for venlafaxine and duloxetine, respectively.
Compliance data collected from pharmacy claims provide a workable estimate of the broader clinical scenario they represent. Although differences between classes of AD were evident, non-compliance was found to be high in the private healthcare environment of SA, comparable with global trends.</description><identifier>ISSN: 0256-9574</identifier><identifier>ISSN: 2078-5135</identifier><identifier>EISSN: 2078-5135</identifier><identifier>DOI: 10.7196/samj.8394</identifier><identifier>PMID: 26242534</identifier><language>eng</language><publisher>South Africa: Health & Medical Publishing Group</publisher><subject>Antidepressants ; Dosage and administration ; Health Care Sciences & Services ; Health Policy & Services ; Medical Ethics ; Medicine, General & Internal ; Medicine, Legal ; Medicine, Research & Experimental ; Patient compliance ; Surveys</subject><ispartof>SAMJ: South African Medical Journal, 2015-02, Vol.105 (2), p.139-144</ispartof><rights>COPYRIGHT 2015 Health & Medical Publishing Group</rights><rights>This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c422t-b41d503053170abbb2de1e43ca3bea396dd7971055bc709655537504154829e73</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,860,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26242534$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Slabbert, Francois Naude</creatorcontrib><creatorcontrib>Harvey, Brian H</creatorcontrib><creatorcontrib>Brink, Christiaan Beyers</creatorcontrib><creatorcontrib>Lubbe, Martha Susanne</creatorcontrib><title>Prospective analysis of the medicine possession ratio of antidepressants in the private health sector of South Africa, 2006 - 2011</title><title>SAMJ: South African Medical Journal</title><addtitle>S Afr Med J</addtitle><description>Major depressive disorder (MDD) is a disabling mental illness with high morbidity and mortality rates. Inadequate treatment efficacy, unfavourable side-effect profiles and consequent shortfalls in compliance are major stumbling blocks in its treatment. Non-compliance data in low- to middle-income countries are lacking.
To investigate the prevalence of antidepressant (AD) non-compliance in the private healthcare sector of South Africa (SA).
We conducted a prospective cohort study analysing AD medicine claims (N=35 175) for 14 135 patients, obtained from a nationally representative pharmaceutical benefit management company, over a 6-year study period (1 January 2006 - 31 December 2011). The medicine possession ratio (MPR) was used as a proxy to determine compliance with AD medication. Only patients >18 years of age whose treatment had been initiated by a psychiatrist following an appropriate International Classification of Diseases (10th edition) (ICD-10) diagnosis of a mood disorder were included. A patient was considered compliant if the MPR was between ≥80% and ≤110% over a >4-month treatment period.
After the first 4 months, only 34% of patients were compliant. A statistically significant association was found between active ingredient consumed and compliance (p<0.0001). Only 26.2% of patients who received amitriptyline-containing products were compliant, compared with 38.8% and 38.7% for venlafaxine and duloxetine, respectively.
Compliance data collected from pharmacy claims provide a workable estimate of the broader clinical scenario they represent. Although differences between classes of AD were evident, non-compliance was found to be high in the private healthcare environment of SA, comparable with global trends.</description><subject>Antidepressants</subject><subject>Dosage and administration</subject><subject>Health Care Sciences & Services</subject><subject>Health Policy & Services</subject><subject>Medical Ethics</subject><subject>Medicine, General & Internal</subject><subject>Medicine, Legal</subject><subject>Medicine, Research & Experimental</subject><subject>Patient compliance</subject><subject>Surveys</subject><issn>0256-9574</issn><issn>2078-5135</issn><issn>2078-5135</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNpVkluL1DAUx4Mo7rj64BeQgCAKdsyladrHYXFXZUVh9Dmk6amToW26Oe3CvvrJTe16GUJIzuH3P5wbIc8522peFe_Q9sdtKav8AdkIpstMcakekg0TqsgqpfMz8gTxyJKtquIxOROFyIWS-Yb8_BoDjuAmfwvUDra7Q480tHQ6AO2h8c4PQMeACIg-DDTayYcFsMPkGxhj8qcvUj_81ozR39oJ6AFsNx0optAhLvw-zMnetdE7-5YKxgqapYfzp-RRazuEZ_fvOfl--f7bxYfs-svVx4vddeZyIaasznmjmGRKcs1sXdeiAQ65dFbWYGVVNI2uNGdK1U6zqlBKSa1YzlVeigq0PCfbNS46D10wxzDHVDCa_dIns_QppaNYatNyVRK8XgVjDDcz4GR6jw66zg4QZjQpD8FKLVWV0Jcr-sN2YPzQhilat-Bml7OUM5Oq_JfBCZVOA713YYDWJ_-J4NV_grWlGLo5jWDAU_DNCro0TozQmjSH3sY7w5lZdsTsd58_mWVHEvvivqy5ThP-S_5ZCvkLKnywrw</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Slabbert, Francois Naude</creator><creator>Harvey, Brian H</creator><creator>Brink, Christiaan Beyers</creator><creator>Lubbe, Martha Susanne</creator><general>Health & Medical Publishing Group</general><general>Health and Medical Publishing Group</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>GPN</scope></search><sort><creationdate>20150201</creationdate><title>Prospective analysis of the medicine possession ratio of antidepressants in the private health sector of South Africa, 2006 - 2011</title><author>Slabbert, Francois Naude ; Harvey, Brian H ; Brink, Christiaan Beyers ; Lubbe, Martha Susanne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c422t-b41d503053170abbb2de1e43ca3bea396dd7971055bc709655537504154829e73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Antidepressants</topic><topic>Dosage and administration</topic><topic>Health Care Sciences & Services</topic><topic>Health Policy & Services</topic><topic>Medical Ethics</topic><topic>Medicine, General & Internal</topic><topic>Medicine, Legal</topic><topic>Medicine, Research & Experimental</topic><topic>Patient compliance</topic><topic>Surveys</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Slabbert, Francois Naude</creatorcontrib><creatorcontrib>Harvey, Brian H</creatorcontrib><creatorcontrib>Brink, Christiaan Beyers</creatorcontrib><creatorcontrib>Lubbe, Martha Susanne</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SciELO</collection><jtitle>SAMJ: South African Medical Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Slabbert, Francois Naude</au><au>Harvey, Brian H</au><au>Brink, Christiaan Beyers</au><au>Lubbe, Martha Susanne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective analysis of the medicine possession ratio of antidepressants in the private health sector of South Africa, 2006 - 2011</atitle><jtitle>SAMJ: South African Medical Journal</jtitle><addtitle>S Afr Med J</addtitle><date>2015-02-01</date><risdate>2015</risdate><volume>105</volume><issue>2</issue><spage>139</spage><epage>144</epage><pages>139-144</pages><issn>0256-9574</issn><issn>2078-5135</issn><eissn>2078-5135</eissn><abstract>Major depressive disorder (MDD) is a disabling mental illness with high morbidity and mortality rates. Inadequate treatment efficacy, unfavourable side-effect profiles and consequent shortfalls in compliance are major stumbling blocks in its treatment. Non-compliance data in low- to middle-income countries are lacking.
To investigate the prevalence of antidepressant (AD) non-compliance in the private healthcare sector of South Africa (SA).
We conducted a prospective cohort study analysing AD medicine claims (N=35 175) for 14 135 patients, obtained from a nationally representative pharmaceutical benefit management company, over a 6-year study period (1 January 2006 - 31 December 2011). The medicine possession ratio (MPR) was used as a proxy to determine compliance with AD medication. Only patients >18 years of age whose treatment had been initiated by a psychiatrist following an appropriate International Classification of Diseases (10th edition) (ICD-10) diagnosis of a mood disorder were included. A patient was considered compliant if the MPR was between ≥80% and ≤110% over a >4-month treatment period.
After the first 4 months, only 34% of patients were compliant. A statistically significant association was found between active ingredient consumed and compliance (p<0.0001). Only 26.2% of patients who received amitriptyline-containing products were compliant, compared with 38.8% and 38.7% for venlafaxine and duloxetine, respectively.
Compliance data collected from pharmacy claims provide a workable estimate of the broader clinical scenario they represent. Although differences between classes of AD were evident, non-compliance was found to be high in the private healthcare environment of SA, comparable with global trends.</abstract><cop>South Africa</cop><pub>Health & Medical Publishing Group</pub><pmid>26242534</pmid><doi>10.7196/samj.8394</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | African Journals Online (Open Access); DOAJ Directory of Open Access Journals; Sabinet African Journals Open Access Collection; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Antidepressants Dosage and administration Health Care Sciences & Services Health Policy & Services Medical Ethics Medicine, General & Internal Medicine, Legal Medicine, Research & Experimental Patient compliance Surveys |
| title | Prospective analysis of the medicine possession ratio of antidepressants in the private health sector of South Africa, 2006 - 2011 |
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