Clinical, economic, and humanistic impact of a multidisciplinary medication review with follow-up for anticoagulated patients treated with vitamin K antagonists in primary care: A cluster randomised controlled trial

Sáez-Benito, Ana; Berenguer, Nuria; Magallón, Rosa; Oliván, Bárbara; Ezquerra, Leyre; Sáez-Benito, Loreto

doi:10.1016/j.sapharm.2023.08.007

Cited by 1 publication

(1 citation statement)

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“…As part of their pharmaceutical care, community pharmacists should provide patients with personalized strategies to achieve optimal adherence to prescribed medications ( Jairoun et al, 2023 ). In fact, there are numerous examples in the literature of successful adherence improvement through community pharmacy initiatives ( Nogueira et al, 2020 ; Jairoun et al, 2023 ; Lallemand et al, 2023 ; Sáez-Benito et al, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

Medication economic burden of antidepressant non-adherence in Spain

Gutiérrez-Abejón,

Pedrosa-Naudín,

Fernández-Lázaro

et al. 2023

Front. Pharmacol.

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Introduction: Non-adherence to antidepressants is associated with worse disease outcomes (morbidity and mortality) and correlates with higher healthcare resource utilization and costs.Methods: A population-based registry study was conducted to assess non-adherence and to analyze the economic burden of treatment and from non-adherence to antidepressants in 2021. Non-adherence was measured by the Medication Possession Ratio and those below 80% were classified as non-adherent.Results: In 2021, 246,718 patients (10.60% [95% CI: 10.48–10.72]) received antidepressants at a cost of €29 million. The median antidepressant cost per patient/year was €70.08€, ranging from €7.58 for amitriptyline to €396.66 for agomelatine. Out-of-pocket costs represented 6.09% of total expenditures, with a median copayment of €2.78 per patient. The 19.87% [95% CI 19.52–20.22)] of patients were non-adherent to antidepressants, costing €3.9 million (13.30% of total antidepressant costs). Non-adherence rates exceeded 20% for the tricyclic antidepressants, fluoxetine (23.53%), fluvoxamine (22.42%), and vortioxetine (20.58%). Venlafaxine (14.64%) and citalopram (14.88%) had the lowest non-adherence rates, of less than 15%. The median cost of non-adherent medications per patient/year was €18.96 and ranged from €2.50 (amitriptyline) to €133.42 (agomelatine).Conclusion: Reducing non-adherence to antidepressants is critical to improving clinical and economic outcomes. The implementation of interventions and standardized measures, including early detection indicators, is urgently needed. Antidepressants differ with regard to non-adherence and their cost, and this should be considered when prescribing this medication. The Medication Possession Ratio could be used by the healthcare provider and clinician to identify non-adherent patients for monitoring, and to take necessary corrective actions.

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