A greater percentage of prescriptions for anti-psychotic medication go unredeemed by patients compared to other drugs, new research from The NHS Information Centre suggests.

A study of 145 GP practices in England from 2004 to 2008 highlighted antipsychotic drugs as having the most notable difference in redemption rate compared to other drugs; at 85.1 per cent compared to the mean average for all drugs of 98.5 per cent.

Today's report; Prescribing Compliance, a review of the proportion of prescriptions dispensed, for the first time compares prescriptions written by GPs and other practice staff against those dispensed by pharmacists – giving a “redemption rate” and examining if patients pick up the medication they are prescribed.

It suggests that most prescriptions are redeemed by patients, although the mean average redemption rate for all prescribing across the practices fell slightly; from 99.6 per cent in 2004 to 98.5 per cent in 2008. The decrease may be due in part to improved recording systems in GP practices.

The study examined the redemption rate for 19 groups of medication within the 145 practices, and if there was any link to deprivation or age.

Deprivation

• There was no apparent consistent relationship between redemption rate and patients' deprivation for most drugs – with the exception of antipsychotic, antidepressant and musculoskeletal medication:
• For antipsychotic medication; in 2007 (the latest year available for this form of analysis) in the most deprived quartile of practices the redemption rate was 87.9 per cent, compared to 82.0 per cent in the most affluent quartile
• However the relationship was the opposite for antidepressant medication, with a lower redemption rate in the most deprived quartile of practices (96.0 per cent) than in the most affluent quartile (97.4 per cent) in 2007. A similar pattern occurred for musculoskeletal medication.

Age

• The study looked at three age groups; elderly patients (aged 60 and over), young patients (aged 16 and under) - both of which are exempt from paying for prescriptions – and those who do not fall into either group.
• Generally, GP practices with a large proportion of prescriptions for elderly patients had the highest redemption rate; while practices with a large proportion of prescriptions for young patients had the lowest.

NHS Information Centre chief executive Tim Straughan said: “The study suggests that in the main, patients are redeeming their prescriptions – but there appears to be a lower redemption rate for antipsychotic prescriptions.

“A patient may not redeem their prescription for several reasons; such as deciding they don't need the medication; or a reluctance to take a drug they have had side effects from previously. A patient may have lost their prescription or obtained their medication through another source – such as during a stay in hospital.

“The cost of prescriptions may also be a factor – although it is worth noting that another NHS IC report shows that only about one in 20 prescriptions are paid for by the patient.”

The report can be viewed at: www.ic.nhs.uk/pubs/presccompliance

ENDS

Notes to editors

1. The NHS Information Centre for health and social care (The NHS IC) is England's authoritative, central, independent source of health and social care information. It works with a wide range of health and social care providers nationwide to provide the facts and figures that help the NHS and social services run effectively. Its role is to collect data, analyse it and convert it into useful information which helps providers improve their services and supports academics, researcher, regulators and policymakers in their work. The NHS IC also produces a wide range of statistical publications each year across a number of areas including: primary care, health and lifestyles, screening, hospital care, population and geography, social care and workforce and pay statistics.
2. The prescribing data comes from the THIN (The Health Information Network) database of anonymised patient records compiled from GP computer systems by the commercial company Cegedim Strategic Data Medical Research Ltd (CSD MR UK). The dispensing data comes from NHS Prescription Services, a division of the NHS Business Services Authority (NHS BSA). All practices contributing data to the THIN database were approached. Of these who consented to be included, there were 145 for whom data was available for all of the five years studied. Data was extracted from the THIN database for 2004, 2005, 2006, 2007 and 2008 for each British National Formulary (BNF) chapter and for selected groups of drugs. Data for these years for these practices was obtained from NHS Prescription Services (RxS), a division of the NHS Business Services Authority. It was not possible to match individual prescriptions and so the comparison is between the total number prescribed and the total number dispensed.
3. Today's report is based on data for 145 (about two per cent) of the approximate 8,500 GP practices in England. In 2008, there were 1.7 million patients registered with the 145 practices covered; about 3.1 per cent of all registered patients in England.
4. The redemption rate is the total number of prescription items dispensed as percentage of the total number of item prescribed.
5. The correlation between the redemption rate and the proportion of prescriptions for those 60 and over was 0.31 (significant at better than 5 per cent) in 2006. The correlation between the redemption rate and the proportion of prescriptions for those under 16 was -0.31 (significant at better than 5 per cent) in 2006.
6. Relationships between redemption rate, deprivation and the proportion of prescriptions for different age groups were explored using Pearson linear correlation. An association was considered significant if the probability of obtaining this value was 5 per cent or less.
7. Information about paid-for prescriptions is available from the report: Prescriptions Dispensed in the Community: England, Statistics for 2000 to 2010; which can be accessed on The NHS IC website at www.ic.nhs.uk
8. For media enquires please call 0845 257 6990 or contact mediaenquiries@ic.nhs.uk