Dataset Information

Cost-related medication nonadherence in Canada: a systematic review of prevalence, predictors, and clinical impact.

ABSTRACT:

Background

Cost-related nonadherence to medications (CRNA) is common in many countries and thought to be associated with adverse outcomes. The characteristics of CRNA in Canada, with its patchwork coverage of increasingly expensive medications, are unclear.

Objectives

Our objective in this systematic review was to summarize the literature evaluating CRNA in Canada in three domains: prevalence, predictors, and effect on clinical outcomes.

Methods

We searched MEDLINE, Embase, Google Scholar, and the Cochrane Library from 1992 to December 2019 using search terms covering medication adherence, costs, and Canada. Eligible studies, without restriction on design, had to have original data on at least one of the three domains specifically for Canadian participants. Articles were identified and reviewed in duplicate. Risk of bias was assessed using design-specific tools.

Results

Twenty-six studies of varying quality (n = 483,065 Canadians) were eligible for inclusion. Sixteen studies reported on the overall prevalence of CRNA, with population-based estimates ranging from 5.1 to 10.2%. Factors predicting CRNA included high out-of-pocket spending, low income or financial flexibility, lack of drug insurance, younger age, and poorer health. A single randomized trial of free essential medications with free delivery in Ontario improved adherence but did not find any change in clinical outcomes at 1 year.

Conclusion

CRNA affects many Canadians. The estimated percentage depends on the sampling frame, the main predictors tend to be financial, and its association with clinical outcomes in Canada remains unproven.

SUBMITTER: Holbrook AM

PROVIDER: S-EPMC7788798 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Cost-related medication nonadherence in Canada: a systematic review of prevalence, predictors, and clinical impact.

Holbrook Anne M AM Wang Mei M Lee Munil M Chen Zhiyuan Z Garcia Michael M Nguyen Laura L Ford Angela A Manji Selina S Law Michael R MR

Systematic reviews 20210106 1

<h4>Background</h4>Cost-related nonadherence to medications (CRNA) is common in many countries and thought to be associated with adverse outcomes. The characteristics of CRNA in Canada, with its patchwork coverage of increasingly expensive medications, are unclear.<h4>Objectives</h4>Our objective in this systematic review was to summarize the literature evaluating CRNA in Canada in three domains: prevalence, predictors, and effect on clinical outcomes.<h4>Methods</h4>We searched MEDLINE, Embase, ...[more]

PMID: 33407875

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Dataset Information

Cost-related medication nonadherence in Canada: a systematic review of prevalence, predictors, and clinical impact.

Background

Objectives

Methods

Results

Conclusion

Publications

Cost-related medication nonadherence in Canada: a systematic review of prevalence, predictors, and clinical impact.

Similar Datasets

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