1- Study Aims 2- Problem Statement 3- Methods 4- Results 5- Conclusions2
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Authors: Hatem Beshir ; Ahmed Kamal; Ahmed ElKhanany; Ahmed Bassiouni Presenter: Dr. Hatem Ahmed Beshir, MBBCh Resident of Cardiothoracic Surgery Organization: Faculty of Medicine, University of Alexandria, Egypt 528 Track: Chronic care Contribution Patient Behavior When Prescribed Non-Affordable Drugs in University Hospitals of Alexandria, Egypt
1- Study Aims 2- Problem Statement 3- Methods 4- Results 5- Conclusions2
1- Study Aims 2- Problem Statement 3- Methods 4- Results 5-
Conclusions2
Slide 3
To Identify cost-reducing strategies, including Cost related
non adherence (CRN). 1 To Understand how are these strategies
employed by chronically-ill patients presenting to Alexandria
University Hospitals. To Examine factors affecting prevalence of
CRN. 3 3 To Explore impact of better Doctor Patient Interaction
(DPI) on CRN. 1 2 3 5 4 To Pinpoint the best DPI methods that
minimized CRN.
Slide 4
4 1. Heisler M, Wagner TH, Piette JD. Clinician identification
of chronically ill patients who have problems paying for
prescription medications. Am J Med. 2004 Jun 1;116(11):753-8 2.
Atella V, Schafheutle E, Noyce P, Hassell K. Affordability of
medicines and patients' cost-reducing behaviour: empirical evidence
based on SUR estimates from Italy and the UK. Appl Health Econ
Health Policy. 2005;4(1):23-35. 3. Wilson IB, Schoen C, Neuman P,
Strollo MK, Rogers WH, Chang H, Safran DG. Physician-patient
communication about prescription medication nonadherence: a 50-
state study of America's seniors. J Gen Intern Med. 2007
Jan;22(1):6-12.
Slide 5
5 4. World Health Organization Statistical Information System
(WHOSIS). World Health Statistics 2010. [Online]. 2010
Apr;(1):130-3. [cited 2010 Aug 18]. Available from:
http://www.who.int/entity/whosis/whostat/EN_WHS10_Full.pdf 5. Arab
Republic of Egypt Central Agency for public mobilization and
statistics health status report 2010. [Online]. 6. Tamblyn R,
Laprise R, Hanley JA, Abrahamowicz M, Scott S, Mayo N, Hurley J,
Grad R, Latimer E, Perreault R, McLeod P, Huang A, Larochelle P,
Mallet L. Adverse events associated with prescription drug
cost-sharing among poor and elderly persons. JAMA. 2001 Jan
24-31;285(4):421-9.
Slide 6
6. Piette JD, Heisler M, Krein S, Kerr EA. The role of
patient-physician trust in moderating medication nonadherence due
to cost pressures. Arch Intern Med. 2005 Aug 8-22;165(15):1749-55.
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Slide 8
Income Ratio : Income Ratio :Drug cost to monthly income
ratio,P=.003 Education: Education: (P=.028) (University 14.2% -
High School 23.8% - Elementary 26.7% - No Education certificate
35.3%). Marital status: Marital status: widowed were 4 times liable
than married to develop CRN (P=.044). Number of medications Number
of medications currently prescribed (per month) : against higher
rates of CRN (p=.003). Patients adopt multiple strategies in CRN to
adopt with drug costs (given a score according to number of methods
used).8 Insurance Coverage: (P