Prospective analysis of the medicine possession ratio of antidepressants in the private health sector of South Africa, 2006-2011
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Date
2015Author
Slabbert, Francois Naude
Harvey, Brian H.
Brink, Christiaan Beyers
Lubbe, Martha Susanna
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Background: Major depressive disorder (MDD) is a disabling mental illness with high morbidity and mortality rates. Inadequate treatment
efficacy, unfavourable side-effect profiles and consequent shortfalls in compliance are major stumbling blocks in its treatment. Noncompliance
data in low- to middle-income countries are lacking.
Objective. To investigate the prevalence of antidepressant (AD) non-compliance in the private healthcare sector of South Africa (SA).
Methods: We conducted a prospective cohort study analysing AD medicine claims (N=35 175) for 14 135 patients, obtained from a
nationally representative pharmaceutical benefit management company, over a 6-year study period (1 January 2006 - 31 December 2011).
The medicine possession ratio (MPR) was used as a proxy to determine compliance with AD medication. Only patients >18 years of age
whose treatment had been initiated by a psychiatrist following an appropriate International Classification of Diseases (10th edition) (ICD-
10) diagnosis of a mood disorder were included. A patient was considered compliant if the MPR was between ≥80% and ≤110% over a
>4-month treatment period.
Results: After the first 4 months, only 34% of patients were compliant. A statistically significant association was found between active
ingredient consumed and compliance (p<0.0001). Only 26.2% of patients who received amitriptyline-containing products were compliant,
compared with 38.8% and 38.7% for venlafaxine and duloxetine, respectively.
Conclusion: Compliance data collected from pharmacy claims provide a workable estimate of the broader clinical scenario they represent.
Although differences between classes of AD were evident, non-compliance was found to be high in the private healthcare environment of
SA, comparable with global trends
URI
http://hdl.handle.net/10394/18355http://www.samj.org.za/index.php/samj/article/view/8394
https://doi.org/10.7196/SAMJ.8394
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- Faculty of Health Sciences [2377]