According to researchers at the University of Bristol, people at risk of heart disease are more likely to receive the correct medication and better treatment if they receive continuity of care.
When a patient repeatedly sees the same doctor, it is known as continuity of care. In a study funded by The National Institute for Health and Care Research (NIHR), researchers from the University of Bristol found evidence the prescription of clinically relevant medications improved with continued care.
The researchers observed that prescriptions for medications such as statins, anticoagulants, antiplatelet agents and antihypertensives increased with greater continued care. These are common medications that if prescribed and taken correctly and reduce the risk of heart disease and stroke.
The researchers examined the records of 173,993 randomly selected patients who had been for four or more general practitioner (GP) appointments two years prior to the study. The research team used five categories of continued care in their study: no continuity, below-average, average, above-average and perfect continuity.
Statin prescription increased with continuity of care
Patients aged 65 or over who were not diagnosed with cardiovascular disease (CVD)-related conditions, with no or below-average continuity of care, were found to be 10-27% less likely to be prescribed statins than patients with above-average continuity of care.
Patients aged 30 or over who were diagnosed with CVD-related conditions, with poorer continuity of care were found to be 9–23% less likely to be prescribed statins than similar patients with above-average continued care.
Increased prescription did not lead to increased adherence
Although an association between continuity of care and the increased prescription was identified, no link between continued care and greater patient adherence was found.
“This is the first time that the association between continuity of care, prescribing and adherence to medications has been described,” said Dr Peter Tammes, from the Centre for Academic Primary Care at the University of Bristol and lead author of the study
“Although we cannot prove a causal association, our findings suggest that prescribing of important cardiovascular medications may be positively influenced by improved continued 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.”
The researchers have urged clinicians and policymakers to consider new strategies to improve continued care. They have indicated that their study has shown the potential for continuity of care to improve GP prescription.
“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,” said Dr Rupert Payne, Associate Professor in Primary Care and Clinical Pharmacology.
