Initiation and Single Dispensing in Cardiovascular and Insulin Medications: Prevalence and Explanatory Factors

Carles Vilaplana-Carnerero, Ignacio Aznar-Lou, María Teresa Peñarrubia-María, Antoni Serrano-Blanco, Rita Fernández-Vergel, Dolors Petitbò-Antúnez, Montserrat Gil-Girbau, Marian March-Pujol, Juan Manuel Mendive, Alba Sánchez-Viñas, Cristina Carbonell-Duacastella and Maria Rubio-Valera
Additional contact information
Carles Vilaplana-Carnerero: Research and Development Unit, Institut de Recerca Sant Joan de Déu, 08830 Barcelona, Catalonia, Spain
Ignacio Aznar-Lou: Research and Development Unit, Institut de Recerca Sant Joan de Déu, 08830 Barcelona, Catalonia, Spain
María Teresa Peñarrubia-María: Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), 28029 Madrid, Spain
Antoni Serrano-Blanco: Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), 28029 Madrid, Spain
Rita Fernández-Vergel: Primary Care Research Institute (IDIAP Jordi Gol), 08007 Barcelona, Spain
Dolors Petitbò-Antúnez: Catalan Institute of Health, 08028 Barcelona, Spain
Montserrat Gil-Girbau: Research and Development Unit, Institut de Recerca Sant Joan de Déu, 08830 Barcelona, Catalonia, Spain
Marian March-Pujol: School of Pharmacy, University of Barcelona, 08028 Barcelona, Catalonia, Spain
Juan Manuel Mendive: Primary Care Research Institute (IDIAP Jordi Gol), 08007 Barcelona, Spain
Alba Sánchez-Viñas: Research and Development Unit, Institut de Recerca Sant Joan de Déu, 08830 Barcelona, Catalonia, Spain
Cristina Carbonell-Duacastella: Research and Development Unit, Institut de Recerca Sant Joan de Déu, 08830 Barcelona, Catalonia, Spain
Maria Rubio-Valera: Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), 28029 Madrid, Spain

IJERPH, 2020, vol. 17, issue 10, 1-17

Abstract: Background: Adherence problems have negative effects on health, but there is little information on the magnitude of non-initiation and single dispensing. Objective: The aim of this study was to estimate the prevalence of non-initiation and single dispensation and identify associated predictive factors for the main treatments prescribed in Primary Care (PC) for cardiovascular disease (CVD) and diabetes. Methods: Cohort study with real-world data. Patients who received a first prescription (2013–2014) for insulins, platelet aggregation inhibitors, angiotensin-converting enzyme inhibitors (ACEI) or statins in Catalan PC were included. The prevalence of non-initiation and single dispensation was calculated. Factors that explained these behaviours were explored. Results: At three months, between 5.7% (ACEI) and 9.1% (antiplatelets) of patients did not initiate their treatment and between 10.6% (statins) and 18.4% (ACEI) filled a single prescription. Body mass index, previous CVD, place of origin and having a substitute prescriber, among others, influenced the risk of non-initiation and single dispensation. Conclusions: The prevalence of non-initiation and single dispensation of CVD medications and insulin prescribed in PC in is high. Patient and health-system factors, such as place of origin and type of prescriber, should be taken into consideration when prescribing new medications for CVD and diabetes.

Keywords: cardiovascular diseases; insulin; adherence; primary care; real-world data; medication initiation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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