Abstract
Objectives To investigate whether better continuity of care is associated with increased prescribing of clinically relevant medication and improved medication adherence.
Setting Random sample of 300 000 patients aged 30+ in 2017 within 83 English general practitioner (GP) practices from the Clinical Practice Research Datalink.
Design Patients were assigned to a randomly selected index date in 2017 on which medication use and continuity of care were determined. Adjusted associations between continuity of care and the prescribing and adherence of five cardiovascular medication groups were examined using logistic regression.
Participants Continuity of Care Index was calculated for 173 993 patients with 4+ GP consultations 2 years prior to their index date and divided into five categories: absence of continuity, below-average continuity, average, above-average continuity and perfect continuity.
Main outcome measures (A) Prescription for statins (primary or secondary prevention separately), anticoagulants, antiplatelet agents and antihypertensives covering the patient’s index date. (B) Adherence (>80%) estimated using medication possession ratio.
Results There was strong evidence (p
Conclusion Better continuity of care is associated with improved prescribing of medication to patients at higher risk of cardiovascular disease but does not appear to be related to patient’s medication adherence.
Setting Random sample of 300 000 patients aged 30+ in 2017 within 83 English general practitioner (GP) practices from the Clinical Practice Research Datalink.
Design Patients were assigned to a randomly selected index date in 2017 on which medication use and continuity of care were determined. Adjusted associations between continuity of care and the prescribing and adherence of five cardiovascular medication groups were examined using logistic regression.
Participants Continuity of Care Index was calculated for 173 993 patients with 4+ GP consultations 2 years prior to their index date and divided into five categories: absence of continuity, below-average continuity, average, above-average continuity and perfect continuity.
Main outcome measures (A) Prescription for statins (primary or secondary prevention separately), anticoagulants, antiplatelet agents and antihypertensives covering the patient’s index date. (B) Adherence (>80%) estimated using medication possession ratio.
Results There was strong evidence (p
Conclusion Better continuity of care is associated with improved prescribing of medication to patients at higher risk of cardiovascular disease but does not appear to be related to patient’s medication adherence.
| Original language | English |
|---|---|
| Article number | e063282 |
| Number of pages | 9 |
| Journal | BMJ Open |
| Volume | 12 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 13 Sept 2022 |
Bibliographical note
Funding Information:This study is funded by the National Institute for Health Research (NIHR) School of Primary Care Research grant funded round 19, PI PT project number 466. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. This study is based on data from the Clinical Practice Research Datalink obtained under licence from the UK Medicines and Healthcare products Regulatory Agency. The data are provided by patients and collected by the NHS as part of their care and support. The interpretation and conclusions contained in this study are those of the authors alone.
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