Effectiveness of medication refilling system for hypertensive patients in a primary care unit, Mueang District, Phetchabun Province, Thailand: A propensity score matching analysis

Abstract

This observational, retrospective, cross-sectional study aimed to evaluate the effectiveness of a medication refilling system for hypertensive patients in a primary care unit in Mueang District, Phetchabun Province, Thailand. A total of 500 medical records of patients attending the primary care unit of Phetchabun Hospital during January 1, 2022-September 30, 2023 were reviewed. Patients were categorized into two groups: those receiving standard treatment and those receiving medication refills. The propensity score analysis using the nearest neighbor matching method was used to control the confounding factors. Descriptive statistics were utilized to depict the number and percentage of demographic data, health status, and risk behaviors. Chi-square tests were employed to examine differences in categorical variables. Univariate and multiple binary logistic regression analyses were conducted, with a significance level set at p-value<0.05. As a result of propensity score analysis, 188 pairs of matched patients who received either standard treatment or medication refills were included into this study. Simple binary logistic regression analysis indicated that the following variables including receiving medication refills, not sufficiently controlling blood pressure before clinic visits, and alcohol consumption were significantly associated with uncontrolled hypertension, with odds ratios of 1.61, 1.59, and 1.70, respectively (p-value=0.03, 0.04, and 0.03). However, from multiple binary logistic regression analysis, variables significantly associated with uncontrolled hypertension were not identified. In conclusion, the medication refilling system for hypertensive patients in a primary care unit was equally effective in controlling blood pressure compared to standard care, despite a higher likelihood of uncontrolled blood pressure. Enhancements to the medication refill system may further improve its effectiveness. Future studies should focus on refining blood pressure measurement processes and ensuring accurate recording of blood pressure values to minimize discrepancies.