LAUSR

INTRODUCTION Primary non-adherence (PNA) to medication occurs when a patient does not fill a prescription, and often leads to suboptimal patient outcomes, lost productivity and increased net costs. Pilot introduction of electronic prescriptions in Poland took place in 2018, enabling nationwide assessment of PNA. OBJECTIVES To determine the prevalence and drivers of primary non-adherence in Poland. METHODS This retrospective analysis included data from all e-prescriptions issued in Poland in 2018. PNA was defined with medication being not collected from the pharmacy within one month from the date of prescription. RESULTS Out of all 119,880 e-prescriptions issued in Poland in 2018, 94.913 were picked, thus making PNA level to reach 20.8%. Although no differences in PNA were observed between genders, age was found to have a significant effect, with older groups demonstrating lower levels of PNA. In addition, slightly lower PNA (17.0%) was found for e-prescriptions issued for selected drugs of key importance (N=47,492). Multivariable analysis performed within this subset found those aged 75+ to demonstrate the lowest odds for non-adherence (OR=0.55, 95% CI=0.48-0.64). Significant PNA variation was observed across therapeutic areas (lowest value in antibiotics, 14.3%), drug classes (lowest value in sulphonylureas, 13.2%), and individual drugs. PNA was lower in drugs covered with the '75+ Program', which makes them free of charge for those aged 75+. CONCLUSIONS High percentage of prescriptions issued in Poland are never filled in. E-prescriptions allow the identification and analysis of drivers of this phenomenon. Our findings may help designing national health and medicine policies.