Physician influence on medication adherence, evidence from a population-based cohort.
<h4>Background</h4>The overall impact of physician prescribers on population-level adherence rates are unknown. We aimed to quantify the influence of general practitioner (GP) physician prescribers on the outcome of optimal statin medication adherence.<h4>Methods</h4>We condu...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0278470 |
| _version_ | 1828065186477506560 |
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| author | Shenzhen Yao Lisa M Lix Gary Teare Charity Evans David F Blackburn |
| author_facet | Shenzhen Yao Lisa M Lix Gary Teare Charity Evans David F Blackburn |
| author_sort | Shenzhen Yao |
| collection | DOAJ |
| description | <h4>Background</h4>The overall impact of physician prescribers on population-level adherence rates are unknown. We aimed to quantify the influence of general practitioner (GP) physician prescribers on the outcome of optimal statin medication adherence.<h4>Methods</h4>We conducted a retrospective cohort study using health administrative databases from Saskatchewan, Canada. Participants included physician prescribers and their patients beginning a new statin medication between January 1, 2012 and December 31, 2017. We grouped prescribers based on the prevalence of optimal adherence (i.e., proportion of days covered ≥ 80%) within their patient group. Also, we constructed multivariable logistic regression analyses on optimal statin adherence using two-level non-linear mixed-effects models containing patient and prescriber-level characteristics. An intraclass correlation coefficient was used to estimate the physician effect.<h4>Results</h4>We identified 1,562 GPs prescribing to 51,874 new statin users. The median percentage of optimal statin adherence across GPs was 52.4% (inter-quartile range: 35.7% to 65.5%). GP prescribers with the highest patient adherence (versus the lowest) had patients who were older (median age 61.0 vs 55.0, p<0.0001) and sicker (prior hospitalization 39.4% vs 16.4%, p<0.001). After accounting for patient-level factors, only 6.4% of the observed variance in optimal adherence between patients could be attributed to GP prescribers (p<0.001). The majority of GP prescriber influence (5.2% out of 6.4%) was attributed to the variance unexplained by patient and prescriber variables.<h4>Interpretation</h4>The overall impact of GP prescribers on statin adherence appears to be very limited. Even "high-performing" physicians face significant levels of sub-optimal adherence among their patients. |
| first_indexed | 2024-04-10T23:10:54Z |
| format | Article |
| id | doaj.art-32e1693222e04426a774b00f6ab0b51e |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-10T23:10:54Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-32e1693222e04426a774b00f6ab0b51e2023-01-13T05:31:45ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011712e027847010.1371/journal.pone.0278470Physician influence on medication adherence, evidence from a population-based cohort.Shenzhen YaoLisa M LixGary TeareCharity EvansDavid F Blackburn<h4>Background</h4>The overall impact of physician prescribers on population-level adherence rates are unknown. We aimed to quantify the influence of general practitioner (GP) physician prescribers on the outcome of optimal statin medication adherence.<h4>Methods</h4>We conducted a retrospective cohort study using health administrative databases from Saskatchewan, Canada. Participants included physician prescribers and their patients beginning a new statin medication between January 1, 2012 and December 31, 2017. We grouped prescribers based on the prevalence of optimal adherence (i.e., proportion of days covered ≥ 80%) within their patient group. Also, we constructed multivariable logistic regression analyses on optimal statin adherence using two-level non-linear mixed-effects models containing patient and prescriber-level characteristics. An intraclass correlation coefficient was used to estimate the physician effect.<h4>Results</h4>We identified 1,562 GPs prescribing to 51,874 new statin users. The median percentage of optimal statin adherence across GPs was 52.4% (inter-quartile range: 35.7% to 65.5%). GP prescribers with the highest patient adherence (versus the lowest) had patients who were older (median age 61.0 vs 55.0, p<0.0001) and sicker (prior hospitalization 39.4% vs 16.4%, p<0.001). After accounting for patient-level factors, only 6.4% of the observed variance in optimal adherence between patients could be attributed to GP prescribers (p<0.001). The majority of GP prescriber influence (5.2% out of 6.4%) was attributed to the variance unexplained by patient and prescriber variables.<h4>Interpretation</h4>The overall impact of GP prescribers on statin adherence appears to be very limited. Even "high-performing" physicians face significant levels of sub-optimal adherence among their patients.https://doi.org/10.1371/journal.pone.0278470 |
| spellingShingle | Shenzhen Yao Lisa M Lix Gary Teare Charity Evans David F Blackburn Physician influence on medication adherence, evidence from a population-based cohort. PLoS ONE |
| title | Physician influence on medication adherence, evidence from a population-based cohort. |
| title_full | Physician influence on medication adherence, evidence from a population-based cohort. |
| title_fullStr | Physician influence on medication adherence, evidence from a population-based cohort. |
| title_full_unstemmed | Physician influence on medication adherence, evidence from a population-based cohort. |
| title_short | Physician influence on medication adherence, evidence from a population-based cohort. |
| title_sort | physician influence on medication adherence evidence from a population based cohort |
| url | https://doi.org/10.1371/journal.pone.0278470 |
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