Diabetes, Hypertension, Inappropriate Prescribing, Medication Adherence
Conditions
Brief summary
This trial evaluates the effect of providing primary care patients with free and convenient access to a set of essential medicines. Half of the participants will receive free and convenient access to these essential medicines, while the other half will have usual access to medicines.
Detailed description
Medication adherence is one important determinant of health outcomes. Approximately one half of treatments for chronic disease are not taken as directed. Cost is one of several important causes of poor adherence and it is particularly important for vulnerable people. The size of many formularies makes it difficult for clinicians to know the safest and most effective medications to prescribe. This may partially explain poor medication selection. Short lists of essential medications have improved the the quality of prescribing.
Interventions
OTHERFree and convenient medicine access
Sponsors
The Ontario Spor Support Unit
Unity Health Toronto
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Cost related medicine non-adherence during last 12 months
Exclusion criteria
* Family member living at same address of patient who is already enrolled in this trial * Patient joined practice during last 6 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Appropriate medicine adherence | During entire study period (24 months) | The percentage of patients taking medicines that are both (1) appropriate based on explicit criteria and (2) taken as prescribed or adhered to for 80 % of doses |
Secondary
| Measure | Time frame |
|---|---|
| Percentage (%) of prescriptions that are adhered to. | During entire study period (24 months) |
| Hemoglobin A1c levels in patients with diabetes (adjusted for baseline) | Assessed between months 21 and 24 inclusive |
| Blood pressure in hypertensive patients (adjusted for baseline) | Assessed between months 21 and 24 inclusive |
| Percentage (%) of prescriptions that are appropriate. | During entire study period (24 months) |
| Healthcare costs including medication costs | During entire study period (24 months) |
| LDL cholesterol levels in patients taking a statin (adjusted for baseline | Assessed between months 21 and 24 inclusive |
Other
| Measure | Time frame | Description |
|---|---|---|
| Count of healthcare encounters | During entire study period (24 months) | Includes ambulatory visits, emergency department visits, hospital admission, investigations and other healthcare utilization. |
Countries
Canada
Outcome results
None listed