Of the 367 patients to whom letters were mailed inviting participation in the study, full medication history interviews were completed for 194 patients (52.9%) who had active PharmaNet profiles. The demographic characteristics of the study subjects are presented in Table 1. One hundred and thirty of the patients interviewed (67.0%) brought all of their prescription medications to the interview. On the basis of PharmaNet records and the patient interview, there was at least one difference in the list of medications currently consumed for 138 patients (71.1%; Table 2). Concordance between PharmaNet and the interview was 0.81 (95% confidence interval [CI] 0.77 to 0.84), and the proportion of medications from the interview that were active according to PharmaNet was 0.83 (95% CI 0.80 to 0.86). One hundred patients (51.5%) claimed to be taking at least one medication that was not listed in PharmaNet or was inactive according to the PharmaNet profile; 31 patients (16.0%) indicated that they were not taking at least one medication that appeared active on the PharmaNet profile. A higher number of currently consumed, regularly administered prescription medications identified during the patient interview was associated with a higher risk of discrepancies (odds ratio 1.31 per medication on the list, 95% CI 1.13 to 1.53; p < 0.001). The use of memory aids (pill boxes) was associated with fewer discrepancies (odds ratio 0.40, 95% CI 0.16 to 1.00; p = 0.05).
Table 1. Characteristics of 194 Patients Interviewed about Prescription Drug Use
Of the 1457 medications reviewed from these lists, 353 (24.2%) were involved in a discrepancy. Most commonly (205 medications for 81 patients), these discrepancies involved medications that were listed somewhere on the 14-month PharmaNet profile and were currently being consumed by the patient, but appeared inactive (i.e., overdue for a refill) based on the number of days supplied at the most recent refill. Of these 205 medications, 72 (35.1%) were overdue by 1 week or less, 69 (33.7%) by 8 to 30 days, and 64 (31.2%) by more than 30 days. Patients’ reasons for being late in obtaining refills are listed in Table 3. While many patients simply “hadn’t got to it yet” or had doses remaining from a previous early refill, many patients described dosing changes relayed verbally by physicians that were not reflected in the PharmaNet profile. A total of 31 medications had been discontinued by patients, most commonly because of adverse effects and often (16/31 or 52%) on the advice of the physician. Twenty-three medications that did not appear anywhere on the PharmaNet profiles were being used by the patients interviewed. These were typically samples issued by physicians. eriacta 100 mg
Figure 1. Bland-Altman agreement plot of the number of prescription medications currently consumed, assessed by examination of PharmaNet data and a patient interview. The size of each circle is proportional to the number of data points, and the line at 0.00 represents no difference.
Table 2. Discrepancies between Medication Lists Obtained from PharmaNet and Information from Patient Interviews*
There were 85 discrepancies in the doses of drugs that were listed on both PharmaNet and the interview list. According to the patients involved, the change in dosewas most commonly the result of adverse effects or lack of efficacy, or to simplify the drug regimen (Table 4). Adrenergic £-receptor blocking agents (^-blockers) and furosemide were the medications most commonly involved in identified discrepancies (Table 5). Viagra Professional
Table 3. Reasons Provided by Patients for Discrepancies between Medication Lists Obtained from PharmaNet and Patient Interviews (n = 268 Medications with Discrepancies)
The total number of regularly administered prescription medications differed between the medication lists obtained from patients and those listed in PharmaNet for 109 (56.2%) of the patients. On average, PharmaNet listed one fewer medication than the list obtained during the interview (Figure 1). For 6 patients, an equal number of medications were listed on PharmaNet and by the patient, but the medications on the lists differed to some degree.
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Table 4. Reasons Provided by Patients for Dosing Discrepancies between Medication Lists Obtained from PharmaNet and Patient Interviews (n = 85 Medications with Discrepancies)
Table 5. Medication Classes Involved in Discrepancies (n = 353 Medications with Discrepancies)