Carefully seLected and Easily Accessible at No Charge Medications

Study Overview
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Brief Summary
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This trial evaluates the effect of providing primary care patients with free and convenient access to a set of essential medicines. Half of the participants will receive free and convenient access to these essential medicines, while the other half will have usual access to medicines.

Detailed Description
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Medication adherence is one important determinant of health outcomes. Approximately one half of treatments for chronic disease are not taken as directed. Cost is one of several important causes of poor adherence and it is particularly important for vulnerable people. The size of many formularies makes it difficult for clinicians to know the safest and most effective medications to prescribe. This may partially explain poor medication selection. Short lists of essential medications have improved the the quality of prescribing.

Official Title
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Carefully seLected and Easily Accessible at No Charge Medications

Conditions
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Medication Adherence, Inappropriate Prescribing, Diabetes, Hypertension

Intervention / Treatment
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* Other: Free and convenient medicine access


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cost related medicine non-adherence during last 12 months Exclusion Criteria: Family member living at same address of patient who is already enrolled in this trial Patient joined practice during last 6 months

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Free and convenient medicine access<br>Free access to a list of essential medicines. Medicines are either mailed to the patient or dispensed at the point of care. | Other: Free and convenient medicine access<br> <br> |
| No Intervention: Usual medicine access<br>Usual access to medicines. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Appropriate medicine adherence | The percentage of patients taking medicines that are both (1) appropriate based on explicit criteria and (2) taken as prescribed or adhered to for 80 % of doses | During entire study period (24 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage (%) of prescriptions that are appropriate. |  | During entire study period (24 months) | 
| Percentage (%) of prescriptions that are adhered to. |  | During entire study period (24 months) | 
| Hemoglobin A1c levels in patients with diabetes (adjusted for baseline) |  | Assessed between months 21 and 24 inclusive | 
| Blood pressure in hypertensive patients (adjusted for baseline) |  | Assessed between months 21 and 24 inclusive | 
| LDL cholesterol levels in patients taking a statin (adjusted for baseline |  | Assessed between months 21 and 24 inclusive | 
| Healthcare costs including medication costs |  | During entire study period (24 months) |