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. 2023 Mar 17;15(2):5-11.
doi: 10.33620/FC.2173-9218.(2023).10. eCollection 2023 Apr 14.

[Prospective observational study of the impact of problems accessing treatment such as risk factors for adherence and persistence. Pilot study]

[Article in Spanish]
Irene Jaraiz Magariños  1 , Alicia F Martínez  2 , Eduardo Satué de Velasco  3 , Eduardo Agustín  4 , José Luis Allué  5 , Silvia López  1
Affiliations

[Prospective observational study of the impact of problems accessing treatment such as risk factors for adherence and persistence. Pilot study]

[Article in Spanish]
Irene Jaraiz Magariños et al. Farm Comunitarios. .

Abstract
in English, Spanish

Introduction: Some preliminary studies that reveal the onset of risk factors not investigated previously in regard to the health system were performed. They can reduce adherence and/or persistence of pharmacological treatments. Knowledge about them can lead to possible solutions.

Aim: To estimate the incidence of risk factors in regard to the health system that can reduce adherence/persistence with treatments associated with problems accessing these in the community pharmacy.

Method: Transversal, randomized, prospective study in community pharmacies in Asturias and Aragón regions. The primary endpoint was the incidence of new risk factors that means that the prescription is inadequate for its dispensing. Different subgroups were analyzed according to type of risk factor, population and prescription.

Results: The typical patient is a vulnerable person according to his age (65.4 years), multipathology and polypharmacy (6.8 drugs). After the evaluation of 138,697 cases of dispensing in 98 community pharmacies a total of 2009 patients were detected with 2221 cases of dispensing with risk factors in terms of adherence and/or persistence (1.6% of the total dispensing). The type of incidence most commonly observed was expiry of the prescription (54.7%; 95%CI=52.6-56.8), followed by no prescription record (18.7%; 95%CI: 17.1-20.3). For its part supply problems stood at 10.2% (95%CI= 10.6%-10.9%). The most compromised therapeutic groups were groups N Nervous System (27.6%), C Cardiovascular System (20.3%) and A Gastrointestinal System (15.3%).

Conclusions: The results obtained suggest that the current incidence of risk factors in regard to the health system in terms of adherence and/or persistence may comprise a health problem with a clinical, quality of life and financial impact. As these risk factors are modifiable, a greater capacity for community pharmaceutical action by means of exceptional dispensing to authorize the treatment's continuity would be an acceptable solution.

Introducción: Se han realizado algunos estudios preliminares que muestran la aparición de factores de riesgo no investigados previamente relativos al sistema sanitario que pueden reducir la adherencia y/o persistencia de los tratamientos farmacológicos. De su conocimiento se pueden explorar posibles soluciones.

Objetivo: Estimar la incidencia de los factores de riesgo relativos al sistema sanitario que pueden reducir la adherencia/persistencia a los tratamientos asociados a problemas de acceso a los mismos en farmacia comunitaria.

Método: Estudio prospectivo aleatorizado transversal en farmacias comunitarias del Principado de Asturias y Aragón. La variable principal es la incidencia de nuevos factores de riesgo que hacen que la prescripción sea inadecuada para su dispensación. Se analizan diferentes subgrupos en función de tipo de factor de riesgo, tipo de población y tipo de prescripción.

Resultados: El paciente tipo es una persona vulnerable en función de su edad (65,4 años), pluripatología y polifarmacia (6,8 medicamentos). Tras la evaluación de 138.697 dispensaciones en 98 farmacias comunitarias se detectaron 2.009 pacientes con 2.221 dispensaciones con factores de riesgo frente a la adherencia y/o persistencia (1,6 % de del total de dispensaciones). El tipo de incidencia más frecuentemente observado fue caducidad de la receta (54,7 %; IC95 %=52,6-56,8), seguido de ausencia de receta (18,7 %; IC95 %: 17,1-20,3). Por su parte los problemas de suministro alcanzaron el 10,2 % (IC95 %= 10,6 %-10,9 %). Los grupos terapéuticos más comprometidos fueron los grupos N-Sistema Nervioso (27,6 %), C-Aparato Cardiovascular (20,3 %) y A-Aparato Digestivo (15,3 %).

Conclusiones: Los resultados obtenidos sugieren que la incidencia actual de factores de riesgo relativos al sistema sanitario frente a la adherencia y/o persistencia pueden constituir un problema de salud con repercusión clínica, de calidad de vida y económica. Siendo dichos factores de riesgo de tipo modificable, una mayor capacidad de actuación del farmacéutico comunitario mediante dispensaciones excepcionales para autorizar la continuidad del tratamiento sería una vía de solución aceptable.

Keywords: Community pharmacy; drug access; persistence; therapeutic adherence.

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Anexo. Formulario de recogida de datos
Anexo. Formulario de recogida de datos
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