• Jesús Mario Arancón-Monge, Alicia de Castro-Cuenca, Ángel Serrano-Vázquez, Luz Campos-Díaz, Ricardo Rodríguez Barrientos, Del Cura-González Isabel I Unidad de Apoyo a la Investigación, Madrid, España; Gerencia Asistencial de Atención Primaria, Madrid, España; Red de Investigación en Servicio, Grupo CAMBIMED, and Integrantes del Grupo CAMBIMED.
• Centro de Salud Tres Cantos I, Tres Cantos, Madrid, España; Gerencia Asistencial de Atención Primaria, Madrid, España.
• Aten Primaria. 2020 Feb 1; 52 (2): 77-85.

ObjectiveTo 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.DesignObservational longitudinal prospective cohort study with a one-year follow-up period between 1 January 2013 and 31 December 2014.LocationPrimary Healthcare Centres in the Community of Madrid.ParticipantsPatients ≥65years-old with a diagnosis of hypertension and/or dyslipidaemia receiving treatment with Enalapril and/or Amlodipine and/or Simvastatin.Main MeasurementsVariables 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.ResultsThe 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%.ConclusionsThe 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.Copyright © 2019 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

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