Medical Dispensation in La Rioja, Spain: Epidemiology and its Relationship with Social Determinants: A Descriptive Study

Gonzalo Aparicio-Rodríguez^1,2Raúl Juárez-Vela^1*Amaya Burgos-Esteban^1,3*Consuelo Sancho⁴José Angel Santos-Sanchez⁴Noelia Navas-Echazarreta¹Ana Cobos-Rincón¹Antonio Cardoso-Muñoz⁵Regina Ruiz De Viñaspre¹Ignacio M Larrayoz¹

• ¹Grupac Research Group. Deparment of Nursing. University of La Rioja., Logroño, Spain
• ²Interuniversity Doctoral Program in Global Health by the University of Zaragoza, the University of La Rioja, the Public University of Navarre, and the University of Lleida., Logroño, Spain
• ³Hospital San Pedro, Logroño, Spain
• ⁴Faculty of Medicine, Universidad de Salamanca, Salamanca, Spain
• ⁵Faculty of Nursing, Universidad de Salamanca, Salamanca, Spain

Abstract: Spain has the highest life expectancy in the European Union (83.2 years in 2022), accompanied by population aging and rising chronic and degenerative disease burdens, leading to increased medication use. In 2022, the National Health System (NHS) dispensed over 1,127.8 million packages. This study evaluates medication dispensation in La Rioja and its relationship with social determinants, including economic conditions, area of residence, age, and sex. We conducted an observational, retrospective, cross-sectional study from January 2016 to December 2023. A total of 4,108,656 raw e-dispensations and 1,433,531 unique patient–ATC4–year records (26 frequent subgroups) were analyzed. We included patients aged ≥14 years with electronic dispensations. Variables included age, sex, socioeconomic level, type and number of dispensations, and basic health zone. Statistical analyses used STATA/SE v.21.0, Chi-square for categorical associations, and Kruskal–Wallis to compare age distributions across ATC4 groups, with significance at p < 0.05. Proton pump inhibitors (PPIs) were the most dispensed medications (82,195, 2016–2023), followed by propionic-acid–derived anti-inflammatory agents. Antidepressant dispensations increased from 5,281 in 2016 to 7,486 in 2023. Women accounted for a higher share (53.7%), with the largest female–male differences in thyroid hormones, vitamin D, and antidepressants. In contrast, cardiovascular medications (e.g., platelet aggregation inhibitors, ACE inhibitors) were more frequently dispensed to men. Among older adults, the most dispensed drugs were those for cardiovascular diseases. By health zone, PPI dispensation was high and homogeneous in Rioja 1 and Rioja 2, whereas anxiolytics and antidepressants were more prominent in San Román and the Guindalera area of Logroño. Socioeconomically, pensioners with limited incomes (IHC 002) primarily received PPIs, paracetamol, and benzodiazepines, while low-income workers (IHC 003) showed high dispensation of propionic acid derivatives, PPIs, and paracetamol, indicating the influence of socioeconomic status on medication use. Conclusions: PPIs and propionic-acid–derived anti-inflammatory drugs are the most dispensed in La Rioja, aligning with national and European patterns. Antidepressant use has increased notably, particularly among women. Socioeconomic determinants, including low income and unemployment, shape access to and use of medications, highlighting vulnerabilities among pensioners and low-income workers. These findings underscore the need to integrate social, economic, and demographic factors