| Summary: | Thesis (MSc. (Med.)(Pharmacy))--University of Limpopo, 2009. === ABSTRACT
Background: When a patient is discharged from the hospital, the doctor may
prescribe medication to be used at home which is called TTO (To Take Out)
medication. Failure by the patient to collect TTO medication might be intentional or
may indicate a lack of appropriate structures and procedures at the hospital to
provide such care on discharge, and/or failure by the health care professionals to
reach concordance with the patient to ensure that he/she continues to take
medications as prescribed.
Objectives: The purposes of this study were to examine the prevalence of primary
non-compliance with medication in this private hospital and to explore its association
with various factors contributing to its existence.
Methodology: The study was conducted at a private hospital in Gauteng, South
Africa. The study focused on discharged patients who did not redeem their TTO
medication. Thus only patients discharged from the hospital within a thirty day period
between 25 May 2009 and 23 June 2009 were included in the study. For each
subject the discharge medication prescription was reviewed and the following
determined: number of items prescribed, number of items dispensed at the hospital
pharmacy, whether any items were non-dispensed, whether any items were partially
dispensed and reason for any item non-dispensed or partially dispensed. A
telephone call was made to those subjects for whom a discharge medication script
was prescribed, but no medication was dispensed at discharge. Information was
collected from the patients to identify possible reasons for not redeeming discharge
medication.
Results: In total 1365 records were evaluated. TTO medication was prescribed for
1161 (85%) patients discharged. All items were redeemed in full by 854 (74%) of the
patients, 118 (10%) patients redeemed no discharge medication, 101 (9%) patients
redeemed only some items prescribed, 74 (6%) patients redeemed all items partly,
14 (1%) patients redeemed some items partly and some not at all and for seven
v
patients details were not known. Four reasons and five types of medication together
accounted for 54% of the total value not redeemed. The four reasons include the
following: medical aid TTO rules, patient unaware of TTO being prescribed, ward
stock given, patient still had stock at home, and the types of medication included:
blood and haematopoietic agents, analgesics, antimicrobials, agents of the
gastrointestinal tract and unclassified.
Conclusion: Some patients reported that they took own decision not to redeem the
medication and some still had stock at home, a fact that should lead healthcare
providers to ensure that they reach concordance with their patients.
|
|---|
