Antidepressants are a commonly prescribed psychotropic medication, and their use has increased in recent years. Medication non-adherence in patients with mental disorders is associated with worse health outcomes. A population-based registry study to assess antidepressant non-adherence during 2021 has been carried out. An indirect method based on the medication possession ratio (MPR) has been utilized. Patients with a MPR under 80% were classified as non-adherent. A multivariate logistic regression to identify non-adherence predictors has been used, considering sociodemographic (age, sex, institutionalization and urbanicity) and health related variables (diagnostics, antidepressant class, multiple prescribers, and polypharmacy). In 2021, 10.6% of the Castile and Leon population used antidepressants. These patients were institutionalized (7.29%), living in urban areas (63.44%), polymedicated with multiple prescribers (57.07%), and using serotonin selective reuptake inhibitors (SSRIs) (54.77%), other antidepressants (46.82%) or tricyclic antidepressants (TCAs) (13.76%). Antidepressants were prescribed mainly for depression (36.73%) and anxiety (29.24%). Non-adherence to antidepressants was more frequent in men (20.56%) than in woman (19.59%) and decreased with increasing age (32% up to 17 years old vs. 13.76% over 80 years old). TCAs were associated with the highest prevalence of non-adherence (23.99%), followed by SSRIs (20.19%) and other antidepressants (18.5%). Predictors of non-adherence in patients on antidepressants were: living in urban areas, using TCAs, and pain occurrence. Non-adherence to antidepressants decreases with aging. Being female, institutionalization, being polymedicated and having depression/anxiety alongside another psychiatric diagnosis are protective factors against non-adherence. The MPR is a robust indicator for the clinician to identify non-adherent patients for monitoring, and adopt any necessary corrective actions.

Background/Objectives: Cardiovascular disease (CVD) remains the leading cause of death worldwide, and the effectiveness of statin therapy is critically dependent on patient adherence and persistence. The aim of this study was to evaluate adherence and persistence in newly started and previously treated statin patients, with reference to cardiovascular prevention. Methods: A retrospective cohort study was conducted to assess adherence and persistence in newly started and previously treated statin patients. Patients aged 18 years or older with a statin claim from 1 January 2021 to 31 December 2023 were included. Adherence was defined as a Medication Possession Rate (MPR) of 80% or greater. Persistence was defined as the time between the index date and treatment discontinuation. Binary logistic regression and Cox proportional hazard regression were used to analyze factors influencing adherence and persistence, respectively. Kaplan–Meier survival analysis was used to compare persistence between both cohorts. Results: Of the 411,956 patients on statins, 81.21% were adherent, with higher rates in the previously treated statin patients (83.05% vs. 73.73%; p = 0.001). Statin persistence decreased from 92.65% at 3 months to 78.28% at 12 months, with higher persistence rates in previously treated statin patients. Previously treated statin patients were more likely to be adherent (AOR: 1.29) and persistent (AHR: 2.08) than those newly started on statins. In secondary prevention patients, adherence was higher in the previously treated cohort (88.09% vs. 79.77%; p = 0.001) than in the newly started cohort (80.52% vs. 71.38%; p = 0.001). Similar results were observed for persistence; 82.97% vs. 81.65% (p = 0.001) and 65.08% vs. 61.57% (p = 0.001), respectively. Conclusions: Adherence and persistence to statins were higher in previously treated patients than in newly started patients, especially for secondary cardiovascular prevention. New strategies are needed to improve medication adherence and persistence in patients with poor cardiovascular prognosis.

The European DRUID (Drive Under the Influence of drugs, alcohol, and medicines) program classifies medications into three categories according to their effect on one’s fitness to drive. The trend in the use of driving-impairing medicines (DIMs) in a region of Spain between 2015 and 2019 was analyzed through a population-based registry study. Pharmacy dispensing records for DIMs are provided. The use of DIMs on drivers was weighted according to the national driver’s license census. The analysis was performed considering the population distribution by age and sex, treatment length, and the three DRUID categories. DIMs were used by 36.46% of the population and 27.91% of drivers, mainly chronically, with considerable daily use (8.04% and 5.34%, respectively). Use was more common in females than in males (42.28% vs. 30.44%) and increased with age. Among drivers, consumption decreases after 60 years of age for females and after 75 years of age for males. There was a 34% increase in the use of DIMs between 2015 and 2019, with a focus on daily use (>60%). The general population took 2.27 ± 1.76 DIMs, fundamentally category II (moderate influence on fitness to drive) (20.3%) and category III (severe influence on fitness to drive) (19.08%). The use of DIMs by the general population and drivers is significant and has increased in recent years. The integration of the DRUID classification into electronic prescription tools would assist physicians and pharmacists in providing adequate information to the patient about the effects of prescribed medications on their fitness to drive.

Background and Objectives: One of the most serious clinical outcomes in hospitalized patients with COVID-19 is severe acute respiratory syndrome (SARS). The aim is to analyze pharmacological treatment, survival and the main mortality predictors. Materials and Methods: A real-world data study from COVID-19-hospitalized patients with SARS from 1 March to 31 May 2020 has been carried out. Variables such as hospital length of stay, ventilation type and clinical outcomes have been taken into account. Results: In Castile and Leon, 14.03% of the 7307 in-hospital COVID-19 patients developed SARS, with a mortality rate of 42.53%. SARS prevalence was doubled in males compared to females, and 78.54% had an age of 65 years or more. The most commonly used medicines were antibiotics (89.27%), antimalarials (68.1%) and corticosteroids (55.9%). Survival of patients developing SARS was lower compared to patients without this complication (12 vs. 13 days). The main death predictors were disseminated intravascular coagulation (DIC) (OR: 13.87) and age (>65 years) (OR: 7.35). Conclusions: Patients older than 65 years who develop DIC have a higher probability of hospital death. Tocilizumab and steroids have been linked to a lower incidence of hospital death, being the main treatment for COVID-19 hospitalized patients with SARS.

Background/Objectives: Poor adherence and persistence to sodium-glucose cotransporter-2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a critical issue in the treatment of type 2 diabetes mellitus (T2DM), especially in patients with cardiovascular disease (CVD). We aimed to compare adherence and persistence to these drugs in routine care. Methods: A retrospective propensity score-matched (PSM) cohort study was conducted using pharmacy claims data. Patients aged 40 years or older with T2DM initiating SGLT-2is or GLP-1 RAs from 1 January 2019 to 31 December 2024 were included. Adherence was measured using the Medication Possession Ratio (MPR), and persistence was defined as the time to discontinuation (gap ≥ 60 days between refills). Results: At the 1-year follow-up, the SGLT-2i cohort showed significantly higher adherence compared to the GLP-1 RA cohort (86.66% vs. 76.53%; OR = 2.02) and higher persistence (71.48% vs. 66.52% at 12 months; HR = 0.83). The main factors associated with lack of persistency were newly diagnosed T2DM (HR = 1.25) and insulin use (HR = 1.32). In the CVD subgroup, the differences in favor of the SGLT-2i cohort were more pronounced for adherence (89.57% vs. 78.12%; OR = 2.44) and persistence (73.9% vs. 63.59%; HR = 0.66). Conclusions: In real-world clinical practice, adherence and persistence rates were higher in patients on SGLT-2is compared to those on GLP-1 RAs, particularly in the CVD subgroup. Our findings suggest that the new strategies are necessary to improve adherence and persistence to these medications, particularly in patients with CVD.