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Is cost-related non-collection of prescriptions associated with a reduction in health? Findings from a large-scale longitudinal study of New Zealand adults
  1. Santosh Jatrana1,
  2. Ken Richardson2,
  3. Pauline Norris3,
  4. Peter Crampton4
  1. 1Alfred Deakin Institute for Citizenship & Globalisation, Deakin University Waterfront Campus, Geelong, Victoria, Australia
  2. 2Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
  3. 3School of Pharmacy, University of Otago, Dunedin, New Zealand
  4. 4University of Otago, Dunedin, New Zealand
  1. Correspondence to Dr Santosh Jatrana; santosh.jatrana{at}deakin.edu.au

Abstract

Objective To investigate whether cost-related non-collection of prescription medication is associated with a decline in health.

Settings New Zealand Survey of Family, Income and Employment (SoFIE)-Health.

Participants Data from 17 363 participants with at least two observations in three waves (2004–2005, 2006–2007, 2008–2009) of a panel study were analysed using fixed effects regression modelling.

Primary outcome measures Self-rated health (SRH), physical health (PCS) and mental health scores (MCS) were the health measures used in this study.

Results After adjusting for time-varying confounders, non-collection of prescription items was associated with a 0.11 (95% CI 0.07 to 0.15) unit worsening in SRH, a 1.00 (95% CI 0.61 to 1.40) unit decline in PCS and a 1.69 (95% CI 1.19 to 2.18) unit decline in MCS. The interaction of the main exposure with gender was significant for SRH and MCS. Non-collection of prescription items was associated with a decline in SRH of 0.18 (95% CI 0.11 to 0.25) units for males and 0.08 (95% CI 0.03 to 0.13) units for females, and a decrease in MCS of 2.55 (95% CI 1.67 to 3.42) and 1.29 (95% CI 0.70 to 1.89) units for males and females, respectively. The interaction of the main exposure with age was significant for SRH. For respondents aged 15–24 and 25–64 years, non-collection of prescription items was associated with a decline in SRH of 0.12 (95% CI 0.03 to 0.21) and 0.12 (95% CI 0.07 to 0.17) units, respectively, but for respondents aged 65 years and over, non-collection of prescription items had no significant effect on SRH.

Conclusion Our results show that those who do not collect prescription medications because of cost have an increased risk of a subsequent decline in health.

  • PUBLIC HEALTH
  • EPIDEMIOLOGY
  • PRIMARY CARE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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