Importance of doctor-patient relationship for patient adherence with medication regimes

Aim: It has been supposed that the relation between the doctor and the patient has implications for the adherence to medication. This study explores the effect of patient reported doctor-patient relationship on patient adherence with medication regiments. Methods: Design: Prospective cohort study of patients' evaluation of the doctor-patient-relation and adherence with new medication regimens. Setting: Primary care in Ringkjoebing County, Denmark in 2004. Participants: 10,972 patients aged 18 and over who had been consulting within a 3-month period evaluated 115 primary care physicians (PCPs) in 48 practices. Doctor-patient relationship was measured from The Danish version of the 23-item EUROPEP questionnaire measuring patient evaluation of general practice. From the register data on prescriptions we drew all subsidised drugs redeemed at pharmacies for each patient in 2002-2005. Patients, who did not have any drug prescriptions one year prior to the evaluation and had at least one new drug prescription for chronic conditions (statins, antihypertensives, SSRI/SNRI, oral antidiabetics) in the year after the evaluation were included as incident, new users of this medication. The adherence was measured as secondary non-compliance and as persistence. The incidence rate ratio of non-adherence was calculated for different levels of the patient evaluated doctor-patient-relationship.Results: A total of 482 patients started new treatment of which 98 were non-compliant and 7 were censored. This study will be the first to estimate the effect of the doctor-patient relationship on adherence. On the same time we will be able to explore if patients, who get more medicine, are more satisfied with their doctor.