Differences between prescribed and dispensed medications

Abstract

Aims: To describe differences between general practice prescribed and dispensed medications in terms of patient characteristics and category of drug.

Methods: Computerised prescribing records and prescriptions presented to pharmacies were retrospectively reviewed. All prescriptions generated from the computers of 13 practices over a 12 week period in 1992 were compared with prescriptions dispensed. Data from the two sources were matched and unmatched items were analysed to determine whether patient demography or category of drug prescribed influenced the rate of prescription dispensing. The nine most commonly prescribed drug categories were examined in detail.

Results: A total of 49 756 items were prescribed to 19 299 people and 43 302 (87.0%) of these were dispensed. Antibiotics were the most commonly prescribed category of the drug accounting for 17.6% of nondispensed items. There was no significant difference by gender in the proportion of people (9.8%) failing to claim prescribed items, nor in the number of items (13.0%) prescribed but not dispensed. Differences in dispensing rates by community services card (CSC) status of patients were statistically significant for both numbers of people failing to uplift their medications and for numbers of items not dispensed (p<0.001). There were also significant differences by high user health card (HUH) eligibility (p<0.005) and age (p<0.001).

Conclusions: There is a high rate of nondispensing of medicines prescribed in general practice. Patients eligible for government subsidies are more likely than other patients to have their prescriptions filled. Current pharmaceutical subsidies may be inadequately targeted. There are no gender differences, while increasing age is associated with lower nondispensing rates. General practitioners need to be aware of these factors when making prescribing decisions.