[ADHEFAP: Clinical trial to evaluate an educational-behavioral telephone intervention by the primary care pharmacist to improve therapeutic adherence]. / ADHEFAP: ensayo clínico para evaluar una intervención telefónica educacional-conductual por el farmacéutico de atención primaria en la mejora de la adherencia terapéutica.

OBJECTIVE: Evaluate the improvement in therapeutic adherence of an intervention based on telephone monitoring by the primary care pharmacist. DESIGN: Randomized open controlled trial. LOCATION: This study was carried out in 2021 by a multidisciplinary team working with health professionals of thirteen health centers belonging to four health districts in Community of Madrid, Spain. PARTICIPANTS: These were patients (60-74 years) with polipharmacy classified as non-adherent according to the Morisky-Green test. Two hundred and twenty-four patients were originally enrolled, 87 of them were non-adherents. Of these, 15 were lost and 72 were finally randomized. Seventy-one patients completed the study (33 intervention group and 38 control group). INTERVENTIONS: Patients randomized to the intervention arm were included in a follow-up telephone program consisting of an interview at months 1, 2, and 3 to improve adherence. The Morisky-Green test was repeated at month 4 to assess improvement. In the control group this test was only performed at month 4. MAIN MEASUREMENTS: Adherence measured by Morisky-Green at baseline and at 4th month. RESULTS: The 72.7% of patients in the intervention group became adherent while only 34.2% did in the control arm, being the difference 38.5% (95% CI: 17.1-59.9), statistically significant (P=.001). CONCLUSIONS: After a follow-up educational-behavioral telephone intervention in non-adherent patients by the primary care pharmacist, therapeutic adherence was improved statistically significantly in the intervention group compared with the control group.

Anxiolytic-like effect of a serotonergic ligand with high affinity for 5-HT1A, 5-HT2A and 5-HT3 receptors.

S-(-)-2-[[4-(napht-1-yl)piperazin-1-yl]methyl]-1,4-dioxoperhydropyrrolo[1,2-alpha]-pyrazine (CSP-2503) is a serotonin (5-HT) receptor ligand with selectivity and high affinity for 5-HT1A, 5-HT2A and 5-HT3 receptors. CSP-2503 reduced rectal temperature and 5-HT neuronal hypothalamic activity in mice, decreased electrical activity of raphe nuclei cells in rats and blocked the enhancement of adenylate cyclase activity induced by forskolin in HeLa cells transfected with the human 5-HT1A receptor. This compound also blocked head-twitches induced by the 5-HT(2A/2C) receptor agonist 2,5-dimethoxy-4-iodoamphetamine (DOI). Contractions of guinea pig ileum induced by the 5-HT3 receptor agonist 2-methyl-5-HT were prevented by CSP-2503. Moreover, it reduced the bradycardia reflex induced by 2-methyl-5-HT in anaesthetized rats. In the light/dark box and social interaction tests, CSP-2503 presented anxiolytic activity, an action shared by 5-HT1 agonists and 5-HT3 antagonists. Taken together, these results suggest that CSP-2503 is a new 5-HT1 receptor agonist with 5-HT2A and 5-HT3)receptor antagonist activities that might be useful in a number of conditions associated with anxiety.