PubMed · 8342498
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Y Gariepy. 1993. Quebec turnaround.. https://pubmed.ncbi.nlm.nih.gov/8342498/
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The purpose of this study was to gain insights into why patients are not compliant with their glaucoma medications. Patients were recruited from lists provided by two ophthalmologists. Each patient had seen a minimum of two ophthalmologists for their glaucoma, and was taking at least two topical medications for glaucoma. Qualitative methodology was utilized, including two focus groups and eleven in-depth interviews in patients' homes. The results showed that forgetfulness was the number one reported reason for non-compliance. Patients did not claim to be non-compliant specifically because of side effects, but they did complain about them. Communication between physicians and patients is a key factor in compliance for glaucoma patients. Specifically, patients would like their physicians to teach them how to instill their eye drops, tell them about new/alternate medications and procedures as they become available, and offer new ways to make their regimen easier. Patients often do not tell their physician if they experience a side effect unless it is intolerable to them, yet they do realize the seriousness of glaucoma, and the consequences of not following their doctor's orders. Finally, while cost was not a reported deterrence to compliance, some patients would prefer less expensive alternatives.
Community pharmacists' knowledge and behavior regarding the collection of copayments for prescription drugs from Medicaid recipients were studied. In fall 1998 a questionnaire was mailed to a random sample of 1465 community pharmacists (one pharmacist per drugstore) in Maryland, Pennsylvania, and West Virginia. The objectives were to determine the extent to which these pharmacists waived copayments for prescription drugs for Medicaid recipients, to document the pharmacists' knowledge of federal policies on Medicaid copayments, and to evaluate the factors associated with pharmacist copayment collection and knowledge of federal copayment policies. A total of 543 pharmacists (37%) responded. Most respondents indicated that they collected copayments for over 90% of drugs dispensed to Medicaid patients subject to copayment policies. Pharmacists most likely to waive Medicaid copayments practiced in drugstores with a high volume of Medicaid-related prescriptions and a large percentage of customers who were elderly Medicaid recipients. Pharmacists least likely to waive copayments believed that doing so would have a negative financial impact on the pharmacy. Nearly three fourths of the pharmacists exhibited fair or good knowledge of federal Medicaid copayment policies, but this varied widely by state. Many said that they would collect copayments in at least some situations even if this opposed federal policy. Pharmacists in Maryland, Pennsylvania and West Virginia had highly variable behavior patterns and knowledge with respect to the collection of drug copayments from Medicaid recipients.
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