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[Effects of changing the appearance of medications in safety and adherence in chronic patients over 65 years of age in primary care. CAMBIMED Study].

Abstract

OBJECTIVE

To study whether the changes in bioequivalent drugs with different appearances are associated with an increase in lack of adherence and medication use errors, in patients >65years old treated with antihypertensive and lipid-lowering medications.

DESIGN

Observational longitudinal prospective cohort study with a one-year follow-up period between 1 January 2013 and 31 December 2014.

LOCATION

Primary Healthcare Centres in the Community of Madrid.

PARTICIPANTS

Patients ≥65years-old with a diagnosis of hypertension and/or dyslipidaemia receiving treatment with Enalapril and/or Amlodipine and/or Simvastatin.

MAIN MEASUREMENTS

Variables collected during a Primary Care consultation by means of a personal interview were: sociodemographic (age, gender, level of education), clinical variables, adherence (Morisky-Green test and direct counting), medication errors (number and type), medication changes and number, analytical (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides) and combined variable (error and/or adherence). There were 1 baseline and 4 quarterly visits.

RESULTS

The study included 274 patients with a mean age 72 (6.6) years, of whom 47.8% were female. Some medication changes were observed in 134 patients (48.9%), with a median of 3 (IQR 1-5) and a maximum of 11 changes. The risk of presenting with a medication use error or decreased adherence was increased in patients exposed to changes in all visits with RR 1.14 (1.16-1.69) at one year of follow-up. The most frequent error was the loss of dose. For each change in medication, the probability of a combined event increases by 41%.

CONCLUSIONS

The changes made in bioequivalent drugs with different appearance could increase the number of medication use errors and decrease the adherence. More studies should be carried out to assess how much this affects the control of the disease. The intervention section is not considered because it is an observational study.

Authors+Show Affiliations

Centro de Salud Tres Cantos I, Tres Cantos, Madrid, España; Gerencia Asistencial de Atención Primaria, Madrid, España.Centro de Salud Jaime Vera, Coslada, Madrid, España; Gerencia Asistencial de Atención Primaria, Madrid, España.Centro de Salud El Puerto, Coslada, Madrid, España; Gerencia Asistencial de Atención Primaria, Madrid, España.Centro de Salud Avenida de Aragón, Madrid, España; Gerencia Asistencial de Atención Primaria, Madrid, España.Unidad de Apoyo a la Investigación, Madrid, España; Gerencia Asistencial de Atención Primaria, Madrid, España; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, España.Unidad de Apoyo a la Investigación, Madrid, España; Gerencia Asistencial de Atención Primaria, Madrid, España; Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, España; Área de Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, España. Electronic address: isabel.cura@salud.madrid.org.No affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

spa

PubMed ID

31481266

Citation

Arancón-Monge, Jesús Mario, et al. "[Effects of Changing the Appearance of Medications in Safety and Adherence in Chronic Patients Over 65 Years of Age in Primary Care. CAMBIMED Study]." Atencion Primaria, 2019.
Arancón-Monge JM, de Castro-Cuenca A, Serrano-Vázquez Á, et al. [Effects of changing the appearance of medications in safety and adherence in chronic patients over 65 years of age in primary care. CAMBIMED Study]. Aten Primaria. 2019.
Arancón-Monge, J. M., de Castro-Cuenca, A., Serrano-Vázquez, Á., Campos-Díaz, L., Rodríguez Barrientos, R., & Del Cura-González, I. (2019). [Effects of changing the appearance of medications in safety and adherence in chronic patients over 65 years of age in primary care. CAMBIMED Study]. Atencion Primaria, doi:10.1016/j.aprim.2019.06.001.
Arancón-Monge JM, et al. [Effects of Changing the Appearance of Medications in Safety and Adherence in Chronic Patients Over 65 Years of Age in Primary Care. CAMBIMED Study]. Aten Primaria. 2019 Aug 31; PubMed PMID: 31481266.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Effects of changing the appearance of medications in safety and adherence in chronic patients over 65 years of age in primary care. CAMBIMED Study]. AU - Arancón-Monge,Jesús Mario, AU - de Castro-Cuenca,Alicia, AU - Serrano-Vázquez,Ángel, AU - Campos-Díaz,Luz, AU - Rodríguez Barrientos,Ricardo, AU - Del Cura-González,Isabel, AU - ,, AU - ,, Y1 - 2019/08/31/ PY - 2018/10/05/received PY - 2019/05/29/revised PY - 2019/06/05/accepted PY - 2019/9/5/entrez KW - Adherence KW - Adherencia KW - Compliance KW - Cumplimiento KW - Dislipidemia KW - Dyslipidaemia KW - Error medicación KW - Generic drugs KW - Hipertensión KW - Hypertension KW - Isoapariencia KW - Medicamentos genéricos KW - Medication appearance KW - Medication error JF - Atencion primaria JO - Aten Primaria N2 - OBJECTIVE: To study whether the changes in bioequivalent drugs with different appearances are associated with an increase in lack of adherence and medication use errors, in patients >65years old treated with antihypertensive and lipid-lowering medications. DESIGN: Observational longitudinal prospective cohort study with a one-year follow-up period between 1 January 2013 and 31 December 2014. LOCATION: Primary Healthcare Centres in the Community of Madrid. PARTICIPANTS: Patients ≥65years-old with a diagnosis of hypertension and/or dyslipidaemia receiving treatment with Enalapril and/or Amlodipine and/or Simvastatin. MAIN MEASUREMENTS: Variables collected during a Primary Care consultation by means of a personal interview were: sociodemographic (age, gender, level of education), clinical variables, adherence (Morisky-Green test and direct counting), medication errors (number and type), medication changes and number, analytical (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides) and combined variable (error and/or adherence). There were 1 baseline and 4 quarterly visits. RESULTS: The study included 274 patients with a mean age 72 (6.6) years, of whom 47.8% were female. Some medication changes were observed in 134 patients (48.9%), with a median of 3 (IQR 1-5) and a maximum of 11 changes. The risk of presenting with a medication use error or decreased adherence was increased in patients exposed to changes in all visits with RR 1.14 (1.16-1.69) at one year of follow-up. The most frequent error was the loss of dose. For each change in medication, the probability of a combined event increases by 41%. CONCLUSIONS: The changes made in bioequivalent drugs with different appearance could increase the number of medication use errors and decrease the adherence. More studies should be carried out to assess how much this affects the control of the disease. The intervention section is not considered because it is an observational study. SN - 1578-1275 UR - https://www.unboundmedicine.com/medline/citation/31481266/[Effects_of_changing_the_appearance_of_medications_in_safety_and_adherence_in_chronic_patients_over_65_years_of_age_in_primary_care._CAMBIMED_Study] L2 - http://www.elsevier.es/en/linksolver/ft/pii/S0212-6567(18)30550-X DB - PRIME DP - Unbound Medicine ER -