Search Results (623)

Background: GLP-1 receptor agonists (GLP-1 RAs) are increasingly used for obesity and metabolic disease, but their use in people with chronic pancreatitis is not a chronic pancreatitis-directed indication and direct evidence is limited. We described recorded outcomes among non-diabetic adults carrying a chronic pancreatitis diagnosis who did or did not have recorded GLP-1 RA exposure. Methods: We performed a retrospective propensity score-matched cohort study using the TriNetX Collaborative Network. Chronic pancreatitis was identified from a recorded diagnosis; supporting imaging, histological, functional, or specialist-confirmation criteria were unavailable. The exposed cohort included patients receiving dulaglutide, semaglutide, or tirzepatide (n = 1441 before matching), and the comparator cohort included patients without recorded GLP-1 RA exposure (n = 142,047 before matching). One-to-one propensity score matching generated 1422 patients in each cohort. Outcomes were assessed from 1 to 1095 days after the index date using risk comparisons and time-to-event analyses. Results: Mean follow-up after matching was 458.8 days in the exposed cohort and 664.4 days in the comparator cohort. Recurrent acute pancreatitis was recorded in 19/799 (2.4%) versus 76/704 (10.8%) patients (HR 0.247, 95% CI 0.149–0.409), pancreatic cancer in 10/1373 (0.7%) versus 40/1345 (3.0%) (HR 0.255, 95% CI 0.128–0.511), and all-cause mortality in 21/1419 (1.5%) versus 157/1416 (11.1%) (HR 0.167, 95% CI 0.105–0.263). A similar direction was observed across several coded outcomes. Vitamin D deficiency showed a higher hazard (HR 1.556, 95% CI 1.129–2.145), although its risk comparison was not significant. Conclusions: These estimates describe outcomes in a selected treatment-exposed phenotype of chronic pancreatitis. The findings are hypothesis-generating and should not guide prescribing decisions. Further prospective studies are required to confirm this hypothesis. Full article

Background: Australia has experienced high rates of antibiotic shortages, yet little is known about how Australian pharmacists experience and manage them. This study aimed to explore Australian community and hospital pharmacists’ experiences of antibiotic shortages, including their perceived clinical impact and approaches to managing shortages. Methods: An exploratory qualitative study using semi-structured interviews was conducted with Australian community and hospital pharmacists between May and August 2024. Participants were recruited via convenience sampling through professional networks and social media. Interviews were audio-recorded, transcribed verbatim, and analysed thematically using an inductive–deductive approach, with coding performed independently by two researchers. Results: Fifteen interviews were conducted before data saturation was reached. Sixty percent of participants were female, 67% worked in hospital settings, and pharmacists were located across five Australian states. Four overarching themes were identified: factors driving shortages, communication and collaboration, impact of shortages, and mitigation and prevention. Pharmacists described antibiotic shortages as frequent and unpredictable, attributing them to supply-chain vulnerabilities, limited manufacturing, and market competition. Shortages were reported to affect treatment choice, contribute to antimicrobial resistance concerns, increase pharmacist workload and stress, and negatively affect patients. Pharmacists used strategies such as stock management, collaboration, and importing alternatives, but felt that lasting solutions required coordinated national action. Conclusions: Australian pharmacists perceive antibiotic shortages as a complex challenge affecting patient care, antimicrobial stewardship, workload, and healthcare efficiency. While pharmacists have developed reactive strategies to manage shortages, stronger communication, collaboration, and national policy coordination, alongside improved supply-chain resilience, are needed to reduce the impact of future shortages. Full article

Product-quality complaints are usually handled as pharmaceutical quality-system events, yet defects in sterility, potency, identity, packaging, labelling, storage, distribution or delivery-device function may affect medication use, treatment continuity and patient outcomes. This structured narrative review examines product-quality complaints (PQCs) as a patient-safety interface linking pharmaceutical quality systems, pharmacovigilance, medication-error prevention, recall action and pharmacoepidemiology. Existing pharmacovigilance, quality-management and recall systems address different components of this pathway, but no integrated framework was identified in the sources reviewed that specifies how product-quality complaints should be linked to exposure evidence and patient outcomes. Sources were identified through targeted PubMed searches and purposive retrieval of official regulatory, pharmacovigilance and public-health documents up to 5 June 2026; the review was not registered and included no quantitative synthesis. The sources identified concentrate on regulatory architecture, sentinel contamination events and shortage-associated harms; routine complaints are studied comparatively little, and no source identified reported the complaint-to-defect-to-exposure-to-outcome cascade with a complaint-level denominator. We propose the term patient-relevant complaint status (PRCS) for a complaint warranting patient-safety triage because the reported defect could plausibly affect exposure, sterility, potency, identity, delivery, medication use or treatment continuity, together with a TRACE workflow, a six-level clinical-consequence classification and separately graded certainty for defect confirmation, patient exposure and outcome attribution. These tools are proposed, unvalidated and hypothesis-generating; they do not convert complaints into adverse reactions, recalls into causality or spontaneous reports into incidence. Their intended role is to structure patient-safety triage, batch-aware linkage, exposure reconstruction, clinical follow-up and proportionate mitigation while causal attribution remains incomplete; this role requires prospective validation before routine implementation. Full article

Background/Objectives: Tenofovir disoproxil fumarate (TDF)-containing regimens remain the cornerstone of first-line antiretroviral therapy (ART) in many low- and middle-income countries. However, concerns regarding treatment failure and antiretroviral resistance highlight the need to evaluate the effectiveness of treatments under routine clinical conditions. This study evaluated the virologic outcomes of treatment-naïve individuals living with HIV who received predominantly TDF-based first-line ART in Davao City, Philippines. Methods: A retrospective observational study was conducted among treatment-naïve HIV patients who initiated ART between 2016 and 2020. Demographic and clinical characteristics, ART regimens, HIV surveillance stage classifications, and viral load results were extracted from routinely collected medical records. Virologic suppression was defined as an HIV RNA viral load of <1000 copies/mL and virologic failure as ≥1000 copies/mL. The availability of viral load monitoring and the interval between ART initiation and the latest viral load measurement were also evaluated. Results: A total of 494 treatment-naïve patients with HIV were included. Most patients were male (97.8%) and received TDF-containing regimens (99.0%), predominantly TDF + 3TC + EFV (95.1%). Viral load results eligible for outcompe analysis were available for 174 (35.2%) patients. Among these patients, 165 achieved virologic suppression, corresponding to a suppression rate of 94.8% (95% CI: 90.5–97.3), whereas virologic failure was observed in nine patients (5.2%; 95p% CI: 2.7–9.5). Viral load availability declined substantially among patients initiating ART in recent years, reflecting shorter follow-up durations and fewer opportunities for routine viral load monitoring. High levels of virologic suppression were observed across the demographic and clinical subgroups. Conclusions: Predominantly TDF-based first-line ART demonstrated high virologic effectiveness among treatment-naïve HIV patients with evaluable viral load measurements, with nearly 95% of patients achieving virologic suppression. However, incomplete viral load monitoring, particularly among patients initiating ART in later years, limits the evaluation of treatment outcomes at the program level. Strengthening routine viral load monitoring and long-term follow-up will improve the future real-world evaluation of ART effectiveness. Full article

Background/Objectives: The increased incidence of obesity and type 2 diabetes, along with the growing use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), particularly semaglutide, among women of childbearing age makes it especially important to assess their safety profile during pregnancy. Methods: A post-marketing study was conducted using reports from the U.S. FDA Adverse Event Reporting System (FAERS) database (2017–2025). Descriptive analyses focused on pregnancy outcomes and fetal/neonatal disorders. Disproportionality analyses assessed adverse event (AE) reporting by System Organ Class (SOC) and pregnancy-related AEs associated with semaglutide versus other medications. A Standardized MedDRA Query (SMQ)-based disproportionality analysis was also performed. Results: A total of 249 cases involving semaglutide use during pregnancy were identified, comprising 922 AEs. “Injury, poisoning and procedural complications” was the most frequently reported SOC, while abortion- and pregnancy loss-related events accounted for 27.3% of reported AEs. Compared with other medications, semaglutide showed higher reporting odds for “Pregnancy, puerperium and perinatal conditions” (ROR 1.59; 95% CI 1.37–1.86), “Injury, poisoning and procedural complications” (ROR 1.93; 95% CI 1.70–2.20), and gastrointestinal disorders (ROR 1.72; 95% CI 1.38–2.15), with no significant association for “Congenital, familial and genetic disorders” or “Reproductive system and breast disorders”. SMQ-based analysis showed increased reporting odds for “Termination of pregnancy and risk of abortion” (ROR 3.71; 95% CI 3.07–4.48). Conclusions: Disproportionate reporting was identified for pregnancy- and perinatal-related events, procedural/exposure-related complications, and pregnancy termination, with no evidence of a disproportionate congenital-anomaly signal. These findings should be interpreted cautiously and do not necessarily indicate a causal association. Full article

Background/Objective: Obesity has been linked to a distinct non-allergic, late-onset, neutrophilic asthma phenotype for more than two decades, yet whether obesity should be regarded as a cause of that phenotype rather than a coexisting comorbidity remains unresolved because randomised allocation to obesity is neither feasible nor ethical. This review asks whether the evidence accumulated between 1995 and 2026 supports a causal interpretation. Methods: A structured narrative synthesis was undertaken. PubMed/MEDLINE, Scopus and Web of Science were searched from January 1995 to June 2026 (the synthesis emphasises the 2020–2026 evidence while drawing on the full window for landmark studies) for cohort, cross-sectional, Mendelian randomisation (MR), interventional, mechanistic and pharmaco-epidemiological studies; landmark earlier work was retained where it remains the primary source for a given viewpoint. The retrieved evidence was mapped onto Sir Austin Bradford Hill’s nine viewpoints (1965) and triangulated using E-values for unmeasured confounding, GRADE, directed acyclic graphs and MR. Results: All nine viewpoints were satisfied to varying degrees. Strength: effect estimates 1.4–6.8, E-values 4.8–13.1, MR summary risk ratio 1.05 per 1 kg/m². Consistency: replication across four continents, both sexes and multiple study designs. Temporality: prospective cohort and life-course MR evidence. Biological gradient: body mass index dose–response for TNFα, IL-17A and Th17 frequency. Plausibility: a twelve-layer architecture from adipose dysfunction to bronchial epithelium. Coherence, experimental evidence (bariatric surgery, lifestyle weight loss, GLP-1 receptor agonists, murine and in vitro models) and analogy were also supported; specificity was met at the phenotype level. Conclusions: The cumulative evidence strongly supports a causal contribution of obesity to the development of the late-onset, non-allergic asthma phenotype while falling short of definitive proof (GRADE: moderate certainty), with implications for primary prevention, endotype-targeted therapy and longitudinal research. Phenotype-stratified MR remains the principal missing element of the causal argument. Full article

Background: Acute angle-closure glaucoma (AACG) is an emergency requiring rapid intervention to prevent irreversible optic nerve damage and permanent vision loss. Methods: This narrative review synthesizes the systemic medication classes most implicated in medication-induced AACG, outlining their underlying pathophysiological mechanisms, typical timing of onset, and practical risk-reduction strategies. Evidence was collected through targeted searches of the PubMed, Google Scholar, Cochrane Library, and Web of Science databases, focusing on major review articles, pharmacoepidemiologic studies, and clinical consensus guidelines. Source selection and data synthesis followed a narrative approach without formal risk of bias assessment or meta-analysis. Results: The literature consistently implicates sulfonamide derivatives (mainly topiramate), serotonergic antidepressants and triptans, potent systemic anticholinergics, and adrenergic decongestants. Sulfonamides typically precipitate bilateral, non-pupillary-block AACG via ciliochoroidal effusion, secondary anterior displacement of the lens-iris diaphragm, and an acute myopic shift. Conversely, serotonergic, anticholinergic, and adrenergic agents typically trigger classic pupillary-block AACG in anatomically predisposed eyes with pre-existing narrow angles. Adverse events predominantly occur shortly after treatment initiation or dose escalation. Management relies on prompt medication discontinuation and rapid intraocular pressure reduction. Importantly, cycloplegics are preferred over miotics in effusion-induced cases. Given the rarity of these events, brief patient education represents a pragmatic and scalable approach, although its direct clinical effectiveness in reducing event rates has not yet been formally established. Conclusions: A select group of widely prescribed systemic medications are associated with most cases of medication-induced AACG. Improving clinician awareness, providing brief patient counseling on warning symptoms, and ensuring prompt ophthalmic evaluation represent the most practical currently available risk-reduction strategies to prevent vision loss. Full article

Background: Atopic dermatitis (AD) and asthma are common type 2 inflammatory diseases linked by the atopic march. In adults with AD, the prevalence of comorbid asthma and the strength of the AD–asthma association remain uncertain, with marked heterogeneity across studies. Moreover, the role of modern systemic therapies in this comorbidity is increasingly debated. Objective: To estimate the global pooled prevalence of asthma in adults with AD, quantify the AD–asthma association, and discuss the potential impact of targeted therapies (dupilumab, abrocitinib, omalizumab) on asthma comorbidity. Methods: Systematic review and random-effects meta-analysis (ID CRD420261304804) of observational studies from PubMed, EMBASE, and Cochrane Library (inception to 19 January 2026). Pooled prevalence and odds ratios (ORs) were calculated, with subgroup analyses by region, ethnicity, and disease definition. Results: Seventy-five studies were included. The global pooled prevalence of asthma in adults with AD was 25.9% (95% CI 22.1–30.0%; I² = 99.9%). AD was significantly associated with asthma (OR 3.64, 95% CI 2.89–4.57; I² = 98.6%). Prevalence varied from 9.3% in Asia to 63.2% in South America. Although dupilumab and other targeted agents are effective in both diseases, isolated reports of new-onset asthma after treatment were identified; these cases more likely reflect the natural progression of AD or unmasking of pre-existing asthma than a direct adverse drug reaction. Conclusions: Asthma is highly prevalent in adults with AD and is strongly associated with AD. Geographic and ethnic disparities call for stratified screening. Clinicians should be aware that new-onset respiratory symptoms during targeted therapy may represent AD-related comorbidity rather than drug-induced asthma. Full article

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and GLP-1/glucose-dependent insulinotropic polypeptide (GIP) dual agonists have revolutionized the treatment of type 2 diabetes and obesity. The rapid growth in public interest, off-label use, and the emergence of counterfeit drugs underscores the need for timely monitoring of information demand. Objective: The objective of this study is to quantitatively characterize the temporal dynamics, market concentration, seasonality, and semantic structure of Russian-language search queries regarding GLP-1RAs and GLP-1/GIP dual agonists and to assess their correlation with pharmaceutical demand. Materials and Methods: This was a retrospective study of Yandex.Wordstat data from March 2018 to March 2026 (covering 97 months, 27 INNs and brand names). Time series analysis (trends, structural breaks, Seasonal-Trend decomposition based on Loess (STL decomposition)), calculation of the Herfindahl–Hirschman Index (HHI), and semantic analysis of 4562 unique formulations (bigrams, trigrams, Term Frequency–Inverse Document Frequency (TF-IDF), thematic classification, morphological normalization) were performed. Validation was conducted using DSM Group pharmacy sales data. Results: A total of 46.05 million queries were analyzed. Interest in semaglutide increased 215-fold, with the structural break point identified in January 2021. The HHI decreased from 0.311 (indicating a highly concentrated market) to 0.141 (indicating a competitive market). The share of diabetes-related queries did not exceed 0.46%, while the share of weight-loss-related queries reached 13.91%, and the share of commercial-component queries reached 41.1%. Four semantic signatures were identified: brand-dominant (Ozempic), instruction-targeted (Saxenda), dose-commercial (Tirzetta), and instruction-commercial (Trulicity). No statistically significant seasonality was confirmed after adjustment for multiple comparisons. The correlation between search interest and pharmacy sales was the strongest for Tirzetta (r = 0.976; n = 8; p < 0.001) and remained significant after trend removal (first differences: r = 0.819; p = 0.024). Conclusions: Yandex.Wordstat data provide a valuable supplementary source for digital pharmacoepidemiology. A systematic discrepancy was found between registered indications and actual information demand, a finding that has significant implications for pharmacovigilance and healthcare planning. Full article

Semaglutide and tirzepatide, glucagon-like peptide-1 (GLP-1) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists, respectively, have revolutionized the management of type 2 diabetes mellitus and obesity. Beyond their established metabolic indications, emerging preclinical and clinical evidence suggests these incretin-based therapies exert pleiotropic effects across multiple organ systems through mechanisms extending beyond glycemic control and weight reduction. This comprehensive review synthesizes current evidence for unconventional applications of semaglutide and tirzepatide across five distinct therapeutic domains: oncology, psychiatry and addiction medicine, orthopedics, aesthetic medicine, and human reproduction. In oncology, both agents demonstrate antitumor activity primarily through immune and metabolic reprogramming rather than direct cytotoxicity, with promising signals in pancreatic, thyroid, breast, and colorectal cancers. In psychiatry, modulation of mesolimbic dopamine reward pathways and GABAergic neurotransmission underlies robust preclinical and observational evidence for reducing alcohol use disorder, substance use, and binge-eating behaviors. Orthopedic applications include clinically meaningful improvements in knee osteoarthritis pain and function, though bone health signals remain mixed. Aesthetic medicine faces the dual challenge of managing GLP-1 receptor agonist-associated facial volume loss while exploring therapeutic potential in inflammatory dermatoses. In reproductive medicine, metabolic improvements translate to benefits in polycystic ovary syndrome and male fertility, though periconception safety concerns persist. Across all domains, evidence derives predominantly from preclinical models, observational cohorts, and pharmacoepidemiologic studies, with randomized controlled trials remaining limited. This review critically evaluates mechanisms, efficacy signals, safety considerations, and research priorities for each application domain, providing a roadmap for translating unconventional uses of semaglutide and tirzepatide into evidence-based clinical practice. Full article

Background: Hepatotoxicity induced by atomoxetine (ATX) and methylphenidate (MPH) when used to treat ADHD is a rare but potentially serious complication. This study aims to describe the hepatic adverse drug reactions (ADRs) reported for ATX and MPH by analysing data from the EudraVigilance database. Methods: Individual case safety reports (ICSRs) listing ATX and/or MPH as suspected drugs and reporting at least one adverse event (AE) within the ‘hepatobiliary disorders’ system organ class (SOC) were extracted for the period from 1 January 2012 to 20 May 2025. Descriptive and disproportionality analyses were then performed. Results: During the study period, 421 ICSRs reporting AEs classified under the “hepatobiliary disorders” SOC and involving ATX and/or MPH as suspected drugs were retrieved (ATX, N = 232; MPH, N = 181). Most cases involved adult (N = 261) and female (N = 222) patients. The majority of reports were classified as serious (N = 349). Overall, 375 AEs were identified. Drug-induced liver injury (DILI) was the most frequently reported AE (N = 103 ATX; N = 47 MPH), followed by hepatitis (N = 20 ATX; N = 9 MPH) and jaundice (N = 15 ATX; N = 20 MPH). The disproportionality analysis, based on a head-to-head comparison, showed a higher reporting frequency of hepatobiliary disorders for ATX compared to MPH (ROR 2.41 [95%CI 2.11–3.11]). Specifically, ATX was associated with significantly higher reporting frequencies than MPH for the AEs of DILI, hepatitis, and jaundice (6.42 [4.45–9.06]; 6.48 [2.95–14.24]; and 2.19 [1.12–4.27], respectively). Conclusions: This analysis, based on the EudraVigilance database, suggests that both drugs are associated with hepatobiliary adverse drug reactions, with a higher overall reporting frequency observed for ATX. Full article

Background: This study aimed to comprehensively investigate the complex association between the use of fluoroquinolone (FQ) antibiotics and cancer risk, with a specific focus on patients with interstitial lung disease (ILD)—a unique clinical population characterized by a high inflammatory burden and a high susceptibility to infections. Methods: We conducted a large-scale retrospective cohort study using a high-quality clinical database. A total of 7906 matched patients (3953 pairs) were included after propensity score matching (PSM). Three complementary statistical models were applied: the standard Cox proportional hazards model, the time-dependent Cox regression model, and the Fine–Gray competing-risks model, to provide a multidimensional assessment of cancer risk. Results: A total of 7906 matched patients (3953 pairs) were followed. After strictly defining the index date to eliminate immortal time bias, FQ exposure was associated with an increased risk of all-cause cancer in the standard Cox model (adjusted HR 1.45; 95% CI, 1.20–1.76) and the competing risk model (adjusted SHR 1.28; 95% CI, 1.06–1.55). Site-specific analyses revealed elevated risks for certain malignancies, notably prostate cancer. Importantly, when modeled as a continuous variable, the cumulative dose of fluoroquinolones showed no significant dose–response relationship with overall cancer risk (adjusted HR 0.99; 95% CI, 0.99–1.00). Conclusions: After correcting for immortal time bias, the previously hypothesized protective effect of fluoroquinolones on cancer risk was not observed. The increased risk observed in categorical models, coupled with a lack of a continuous dose–response, strongly suggests that these findings are driven by confounding by indication and reverse causation (i.e., frequent infections masking undiagnosed malignancies or reflecting severe underlying ILD), rather than a direct pharmacological effect. Full article

Background: Knee osteoarthritis (KOA) is often framed as degenerative knee pain, yet behaves as a decades-long care pathway in which medication, injections, comorbidity, productivity loss, and surgery accumulate into a major economic footprint. This critical narrative review synthesizes pharmacoeconomic and pharmacoepidemiologic evidence across that pathway. Methods: Structured source identification was conducted in PubMed, Web of Science, Scopus, and Google Scholar for publications from 2000 to 2026, with citation tracking. Sources were appraised against predefined critical-interpretation domains and mapped narratively rather than pooled; no meta-analysis was performed. Results: Global Burden of Disease 2019 estimates approximately 364.6 million prevalent KOA cases worldwide. Reported evidence indicates that KOA spending is highly concentrated: in a large U.S. claims analysis, knee arthroplasty was performed in approximately 8.8% of patients yet accounted for 61.5% of KOA-related costs, whereas hyaluronic acid represented 3.0% of overall costs; the remaining pathway burden was distributed across years of outpatient care, analgesics, injections, and other nonsurgical utilization. Medication and injection findings were stage- and phenotype-dependent, and observational studies associated opioid exposure with higher fall risk, healthcare utilization, and cost. Intra-articular hyaluronic acid was repeatedly associated with longer time to arthroplasty, interpreted here as an association limited by confounding and immortal-time bias, not a causal effect; platelet-rich plasma value remained price- and durability-sensitive. Conclusions: KOA economics resembles an iceberg—arthroplasty is the visible peak, while the submerged mass is years of pathway-level care. Value-based policy should measure the full pathway, not the surgical episode, using linked claims, registries, patient-reported outcomes, and productivity data. Full article

Seasonal influenza remains an important public health concern worldwide, and pregnant women represent a particularly vulnerable population due to physiological and immunological changes associated with gestation. Influenza infection during pregnancy has been associated with adverse maternal, fetal and neonatal outcomes. This narrative review summarizes current evidence regarding maternal influenza infection and influenza vaccination during pregnancy. A structured literature search was conducted using PubMed, Embase and Cochrane Library databases. Studies published between 2020 and 2025 addressing maternal influenza infection, pregnancy outcomes and influenza vaccination were reviewed. Current evidence suggests that maternal influenza infection is associated with increased risks of spontaneous abortion, preterm birth, hospitalization and congenital malformations, especially neural tube defects and congenital heart defects when infection occurs during the first trimester. In contrast, evidence regarding long-term neurodevelopmental outcomes remains inconsistent. Influenza vaccination during pregnancy demonstrates moderate-to-high effectiveness in preventing maternal and neonatal influenza infection and shows a favorable safety profile. Available evidence also suggests that neuraminidase inhibitors, particularly oseltamivir, can be used safely during pregnancy without increasing the risk of congenital malformations or adverse neonatal outcomes. Influenza vaccination during pregnancy should continue to be promoted as a safe and effective public health strategy to protect both mothers and infants. Full article

Background/Objectives: Medication adherence is a critical determinant of therapeutic outcomes in type 2 diabetes mellitus (T2DM); however, its relationship with glycemic control remains inconsistent, particularly in real-world and socially vulnerable settings. This study aimed to evaluate medication adherence using multiple validated instruments, assess disease-related knowledge, and examine their relationship with glycemic control, with a focus on potential discordance between self-reported adherence and objective metabolic outcomes. Methods: A cross-sectional analytical study was conducted with 237 adults with T2DM receiving care in a primary health care (PHC) unit in the Brazilian Amazon. Medication adherence was assessed using the Almeida Adherence Scale, ARMS-12, and the Haynes–Sackett test, while disease-related knowledge was evaluated using the Batalla–Martínez questionnaire. Glycemic control was determined based on glycated hemoglobin (HbA1c) values obtained from clinical records within the previous three months. Descriptive and comparative analyses were performed. Results: The study population was predominantly female (64.1%) and aged 40–59 years (55.7%), with a high prevalence of socioeconomic vulnerability. Non-adherence was identified in 55.7% of participants using the Almeida Adherence Scale, whereas higher adherence rates were observed with ARMS-12 (91.1%) and the Haynes–Sackett test (72.2%). Inadequate disease-related knowledge was found in 77.2% of participants. Among individuals with available HbA1c data (n = 116), the mean HbA1c was 8.63% (SD = 1.65), and 81.9% presented inadequate glycemic control (HbA1c ≥ 7%). Notably, among participants classified as adherent by the ARMS-12 scale (91.1%), inadequate glycemic control was nonetheless present in 81.9% of those with available HbA1c data, illustrating the magnitude of the observed discordance between self-reported adherence and objective metabolic outcomes. Cross-tabulation of each adherence instrument against glycemic control showed no statistically significant associations (chi-square with Yates correction; ARMS-12: p = 0.631, φ = 0.045; Almeida Adherence Scale: p = 0.301, φ = 0.096; Haynes–Sackett: p = 0.800, φ = 0.024). Multivariable logistic regression (Nagelkerke R² = 0.321; AUC = 0.834) identified older age (aOR = 0.92; 95% CI: 0.87–0.96; p < 0.001) and higher income (aOR = 9.96; 95% CI: 2.05–48.32; p = 0.004) as independent predictors of glycemic outcome, while no adherence measure was independently associated with HbA1c ≥ 7%. A sensitivity analysis using HbA1c ≥ 8.0% revealed poor control in 59.5% of participants (n = 69/116). Conclusions: Despite varying levels of self-reported medication adherence, inadequate glycemic control was highly prevalent. The absence of statistically significant associations between self-reported adherence and HbA1c, combined with the high prevalence of poor glycemic control regardless of adherence status, is consistent with the hypothesis that adherence alone does not fully explain metabolic outcomes in T2DM. Given the cross-sectional design, no causal inferences can be drawn. These findings highlight the need for integrated care strategies in primary health care, including improved health literacy, structured pharmacotherapeutic follow-up, and the use of multiple adherence assessment tools to better inform clinical decision-making. Full article