When we prescribe medications for our patients, we expect that the prescription will be filled, and the medication taken. Of course, we know that this is not always the case (haven’t we all failed to take prescriptions as recommended ourselves?). What about that first step of even filling the prescription that is sent over to the local pharmacy? How often do families fill those prescriptions for their child?
To answer that question, Carbonell-Duacastella et al (10.1542/peds.2020-034371) share with us an analysis of 1.5 million new prescriptions ordered for 715,895 children less than 18 years of age in Catalonia Spain from July 2017 to June 2018. A new prescription was defined as being one for which no similar type of medication had been prescribed in the prior 6 months. The authors then looked at whether a prescription was filled in 1 or 6 months after prescribing it, and what factors were associated with unfilled prescriptions. The results are likely to surprise you. 9% of prescriptions were not filled at 1 month after ordering the medication, and 8.5% at the 6-month point. In addition, the prevalence of non-initiation was highest in children who were both youngest and oldest in age, and in underserved populations who did not have to co-pay for the prescription. As to medications whose prescriptions were not initiated, the authors found that proton pump inhibitors led the list at 21.5% with oral antibiotics in last place but still at 2.6%.
So why would these findings be occurring, and what can we do about them? The authors offer some terrific insight into their results in the discussion section of their article. Before you write the next prescription for your patients, I would prescribe that you swallow a good dose of information contained in this study, which, in turn, may enable you to better strategize steps needed to ensure better compliance with picking up the medications you feel are indicated for the health and wellbeing of your patients. While this study took place in Spain, the generalizability is likely broad, so link to this study and reflect on how it may result in improved initiation of filling prescriptions in your practice.