Evidence map›Paper›PMID 34301661›Full record

ArticleBMJ open2021

Impact of removing prescription charges on health outcomes: protocol for a randomised controlled trial.

Kimberly Cousins, Pauline Norris, Simon Horsburgh, Alesha Smith, Shirley Keown, Ariyapala Samaranayaka, Carlo Marra, Marianna Churchward

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Preference-based measures of health-related quality of life in Indigenous people: a systematic review.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024
    Pooled it
  2. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kimberly CousinsCentre for Pacific Health, University of Otago Division of Health Sciences, Dunedin, New Zealand kim.cousins@otago.ac.nz.ORCID 0000-0002-3449-8295
Pauline NorrisCentre for Pacific Health, University of Otago Division of Health Sciences, Dunedin, New Zealand.
Simon HorsburghPreventive and Social Medicine, University of Otago-Dunedin Campus, Dunedin, New Zealand.
Alesha SmithSchool of Pharmacy, University of Otago Division of Health Sciences, Dunedin, New Zealand.
Shirley KeownTuranga Health, Gisborne, New Zealand.
Ariyapala SamaranayakaCentre for Biostatistics, University of Otago Division of Health Sciences, Dunedin, New Zealand.
Carlo MarraSchool of Pharmacy, University of Otago Division of Health Sciences, Dunedin, New Zealand.
Marianna ChurchwardHealth Services Research Centre, Victoria University of Wellington, Wellington, New Zealand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPrescription charges prevent many people from accessing the medicines they need to maintain or improve their health. In New Zealand, where most people pay $5 per prescription item, Māori and Pacific peoples, those living in most deprived areas and those with chronic health conditions are the most likely to report that cost prevents them from accessing medicines. METHODS AND ANALYSIS: This randomised controlled trial (RCT) will evaluate the effect of removing prescription charges on health outcomes and healthcare utilisation patterns of people with low income and high health needs. We will enrol 2000 participants: half will be allocated to the intervention group and we will pay for their prescription charges for 12 months. The other half will receive usual care. The primary outcome will be hospital bed-days. Secondary outcomes will be: all-cause and diabetes/mental health-specific hospitalisations, prescription medicines dispensed (number and type), deaths, emergency department visits and quality of life as measured by the 5-level EQ-5D version. Costs associated with these outcomes will be compared in an economic substudy. A qualitative substudy will also help understand the impact of free prescriptions on participant well-being using in-depth interviews. DISCUSSION: Being unable to afford prescription medicines is only one of many factors that influence adherence to medicines, but removing prescription charges is relatively simple and in New Zealand would be cheap compared with other policy changes. This RCT will help identify the extent of the impact of a simple intervention to improve access to medicines on health outcomes and health service utilisation. ETHICS AND DISSEMINATION: This study was approved by the Central Health and Disability Ethics Committee (NZ) in July 2019 (19/CEN/33). Findings will be reported in peer-reviewed publications, as well as in professional newsletters, mainstream media and through public meetings. TRIAL REGISTRATION NUMBER: ACTRN12618001486213p.

Indexed as

Fees and ChargesQuality of LifeChronic DiseaseHumansNew ZealandPrescriptionsRandomized Controlled Trials as Topichealth economicshealth policyhealth services administration & management

Identifiers

PMID34301661
PMCPMC8728355

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.