Population-Based Registry Analysis of Antidiabetics Dispensations: Trend Use in Spain between 2015 and 2018 with Reference to Driving

Abstract

Insulins and some oral antidiabetics are considered to be driving-impairing medicines (DIM) and they belong to the Driving under the Influence of Drugs, alcohol, and medicines (DRUID) category I (minor influence on fitness to drive). The trend of antidiabetics use in Castilla y León from 2015 to 2018 is presented through a population-based registry study. Treatment duration with these medicines and the concomitant use of other DIMs were observed. An adjustment method was used with information from the drivers’ license census. For all calculations, age and gender were taken into account. 3.98% of the general population used at least one antidiabetic, as well as 2.92% of drivers. The consumption of antidiabetics in men was higher than in women (4.35% vs. 3.61%, p = 0.001), and the use increases with age, especially from 35–39 years to 75–79 years in men and 85–89 years in women. Antidiabetics were consumed chronically, specifically 100% in the case of insulins and 95% in the case of oral antidiabetics. In addition to antidiabetics, 2.5 ± 1.86 DIMs were consumed, mainly anxiolytics (25.53%), opioids (23.03%), other analgesics and antipiretics (19.13%), and antidepressants (17.73%). Collaboration between pharmacists and physicians is a priority to clearly transmitting risks to patients. It is necessary that the health authorities include information on DIMs, such as the DRUID classification, in the prescription and dispensing software.

Non-Adherence to Antidepressant Treatment and Related Factors in a Region of Spain: A Population-Based Registry Study

“…Since a real scenario was involved, as in previous manuscripts by our group [3,[35][36][37][38][39][40], all dispensations were considered equivalent to consumption. In Castile and Leon, medicines can be prescribed acutely or chronically.…”

Trends in the use of antihistamines with reference to drivers between 2015 and 2019: A population‐based registry analysis

“…According to our findings, the mandatory prescription antihistamines consumed in Spain are relatively safe for driving, with the exception of first-generation antihistamines, whose consumption is minority. However, it is essential to consider the considerable concomitant use of other DIMs that seriously affect driving ability, especially benzodiazepines [17], antipsychotics [18], opioids [19], antidepressants [20], or antidiabetics [21]. Therefore, it is an important consideration, since around 50% of the population that used a safe antihistamine for driving also consumed more than 2 DIMs, and 75% of daily users of these antihistamines also used almost 3 DIMs.…”

“…Since 2011, in Spain all DIMs include the "medicines and driving" pictogram on the packaging, aiming to improve knowledge about the effects of these medicines on driving abilities. CONCYLIA database does not contain information about driving, so as in previous studies, weighting was performed, taking into account the Castile and Leon population, to obtain the adjusted antihistamines consumption for licensed drivers according to age and gender using the Castile and León drivers' license census data (http://www.dgt.es/es/segur idad-vial/estad istic as-e-indic adore s/permi sos-condu ccion/) [16][17][18][19][20][21]. We can assume that the dispensing is equivalent to the use, and that the use can be considered an approximation to the real consumption, as our public health system dispensed more than 95% of the total amount consumed [25].…”

“…In addition, since antihistamine can be sedating, especially the first-generation, their use between the general population and drivers has been compared. For this, the antihistamines use has been adjusted according to the driver's license census [16][17][18][19][20][21]. Finally, concomitant use of systemic antihistamines with other driver impairing medicines (DIM) has been taken into account.…”

“…drive is not considered. On the other hand, CONCYLIA contains no information on driving licenses, so an estimation has been performed with the Castile and Leon driver's license census data with adjusting for age and gender as previously made [16][17][18][19][20][21]. Another possible limitation is that, in the selection of antihistamines, hydroxyzine (ATC group N05BB01) has not been taken into account, since in Spain and other European countries it is mainly used as an anxiolytic [31], what can generate an underestimation of antihistamines consumption.…”