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Authors: Hatem Beshir ; Ahmed Kamal; Ahmed ElKhanany; Ahmed Bassiouni

Patient Behavior When Prescribed Non-Affordable Drugs in University Hospitals of Alexandria, Egypt. Track: Chronic care. Authors: Hatem Beshir ; Ahmed Kamal; Ahmed ElKhanany; Ahmed Bassiouni Presenter : Dr. Hatem Ahmed Beshir, MBBCh Resident of Cardiothoracic Surgery

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Authors: Hatem Beshir ; Ahmed Kamal; Ahmed ElKhanany; Ahmed Bassiouni

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  1. Patient Behavior When Prescribed Non-Affordable Drugs in University Hospitals of Alexandria, Egypt Track: Chronic care 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 Contribution

  2. 528 Agenda

  3. 528 Study Aims 1 1 To Identify cost-reducing strategies, including Cost related non adherence (CRN). To Understand how are these strategies employed by chronically-ill patients presenting to Alexandria University Hospitals. 2 3 3 To Examinefactors affecting prevalence of CRN. To Exploreimpact of better Doctor Patient Interaction (DPI) on CRN. 4 To Pinpoint the best DPI methods that minimized CRN. 5

  4. 528 Problem Statement (1/3) • Inadequate doctor–patient interaction regarding drug costs (DPI) is a major factor in CRN. We investigate the impact of drug costs on patients’ behavior, most notably CRN, and DPI’s role in minimizing it. • Increasing drug costs is a constant challenge to health care delivery, and patients respond in turn by employing various cost-reducing strategies. Cost-related non-adherence (CRN) is the main strategy described • A careful analysis of these factors should allow better interventional recommendations tailored to each community. 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.

  5. 528 Problem Statement (2/3) 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.

  6. 528 Problem Statement (3/3) Drug Non Adherence is Multifactorial 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.

  7. 528 Methods Study Design : Cross-sectional Study

  8. 528 Results (1/5) • Insurance Coverage: (P <. 001) (Non Insured 75.9% , Public 22.4%, Private 1.7%) Better DPI regarding drug costs (p = .004)

  9. 528 Results (2/5)

  10. 528 Results (3/5) Better DPI regarding drug costs (p = .004)

  11. 528 Results (4/5)

  12. 528 Results (5/5)

  13. 528 Conclusions (1/2)

  14. 528 Conclusion (2/2)

  15. Thank You Hatem Beshir

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