Better continuity of care is linked with improved prescribing of medicines in patients at risk of cardiovascular disease, but does not necessarily mean they take their pills, research has shown.
Prescriptions for statins, anticoagulants, anti-platelets and antihypertensives were all more likely with greater continuity of care, an analysis by researchers at the University of Bristol found.
For primary prevention in the over-65s, patients were 10%–27% less likely to be prescribed statins if they had no or below average continuity of care than similar patients with above-average continuity of care, the study in BMJ Open reported
Younger patients aged 30 or over with cardiovascular disease and poorer continuity of care were 9%–23% less likely to be prescribed statins than similar patients with above-average continuity of care.
The analysis of records of almost 174,000 patients who had four or more consultations in the previous four years showed that having the same GP was generally not linked with better adherence except in the case of statins for secondary prevention.
Patients with below-average continuity of care were 21% less likely to be prescribed anticoagulants than patients with above-average continuity of care and for antiplatelets were 45% less likely to be prescribed when there was no continuity the team found.
Dr Peter Tammes, from the Centre for Academic Primary Care, University of Bristol, and lead author of the study, said this was the first time that the association between continuity of care, prescribing, and adherence to medications has been described.
‘Although we cannot prove a causal association, our findings suggest that prescribing of important cardiovascular medications may be positively influenced by improved continuity of primary care.
‘There is less evidence for improved adherence to ongoing medication, which was a surprising result.
‘We had also expected that perfect continuity of care might be associated with poorer prescribing and adherence, due to over-familiarity between the patient and GP but, reassuringly, our findings do not support this.’
Co-author, Dr Rupert Payne, associate professor in primary care and clinical pharmacology said the results showed that there is the potential for continuity of care to improve GP prescribing.
‘We would encourage clinicians and policymakers to consider strategies to increase continuity of care with this goal in mind.
‘Future research should explore the reasons for these findings in more detail and consider whether continuity may also impact other relevant aspects of medication use, including drug safety and overprescribing.’
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