PowerPoint Presentation

Authors: Hatem Beshir; Ahmed Kamal; Ahmed ElKhanany; Ahmed BassiouniPresenter: Dr. Hatem Ahmed Beshir, MBBChResident of Cardiothoracic Surgery Organization: Faculty of Medicine, University of Alexandria, Egypt

528Track: Chronic careContribution Patient Behavior When Prescribed Non-Affordable Drugs in University Hospitals of Alexandria, Egypt

Agenda2528

Study AimsTo Identify cost-reducing strategies, including Cost related non adherence (CRN).1To Understand how are these strategies employed by chronically-ill patients presenting to Alexandria University Hospitals.To Examine factors affecting prevalence of CRN.33To Explore impact of better Doctor Patient Interaction (DPI) on CRN.12354528To Pinpoint the best DPI methods that minimized CRN.

Increasing drug costs is a constant challenge to health care delivery, and patients respond in turn by employing various cost-reducing strategies. Cost-related non-adherence (CRN) is the main strategy described A careful analysis of these factors should allow better interventional recommendations tailored to each community. Inadequate doctorpatient interaction regarding drug costs (DPI) is a major factor in CRN. We investigate the impact of drug costs on patients behavior, most notably CRN, and DPIs role in minimizing it. Problem Statement (1/3)45281. Heisler M, Wagner TH, Piette JD. Clinician identification of chronically ill patients who have problems paying for prescription medications. Am J Med. 2004 Jun 1;116(11):753-82. Atella V, Schafheutle E, Noyce P, Hassell K. Affordability of medicines and patients' cost-reducing behaviour: empirical evidence based on SUR estimates from Italy and the UK. Appl Health Econ Health Policy. 2005;4(1):23-35.3. Wilson IB, Schoen C, Neuman P, Strollo MK, Rogers WH, Chang H, Safran DG. Physician-patient communication about prescription medication nonadherence: a 50-state study of America's seniors. J Gen Intern Med. 2007 Jan;22(1):6-12.

Problem Statement (2/3)55284. World Health Organization Statistical Information System (WHOSIS) . World Health Statistics 2010. [Online]. 2010 Apr;(1):130-3. [cited 2010 Aug 18]. Available from: http://www.who.int/entity/whosis/whostat/EN_WHS10_Full.pdf5. Arab Republic of Egypt Central Agency for public mobilization and statistics health status report 2010. [Online].6. Tamblyn R, Laprise R, Hanley JA, Abrahamowicz M, Scott S, Mayo N, Hurley J, Grad R, Latimer E, Perreault R, McLeod P, Huang A, Larochelle P, Mallet L. Adverse events associated with prescription drug cost-sharing among poor and elderly persons. JAMA. 2001 Jan 24-31;285(4):421-9.

6. Piette JD, Heisler M, Krein S, Kerr EA. The role of patient-physician trust in moderating medication nonadherence due to cost pressures. Arch Intern Med. 2005 Aug 8-22;165(15):1749-55. Problem Statement (3/3)6528Drug Non Adherence is Multifactorial

MethodsStudy Design : Cross-sectional Study7528Results (1/5)8528

Insurance Coverage: (P