J Am Pharm Assoc (2003). 2021 Mar-Apr;61(2):e100-e113. doi: 10.1016/j.japh.2020.10.017. Epub 2020 Nov 25.
Telepharmacies, which dispense medications on-site under the supervision of an off-site pharmacist using telecommunication technologies, have been proposed as a means to ameliorate the impact of pharmacy closures and improve access to medications.
To examine whether adherence varies among individuals filling prescription medications through a telepharmacy versus a traditional pharmacy in an urban neighborhood.
We conducted a retrospective cohort study using dispensing records of a traditional pharmacy and a telepharmacy, located in the same low-income Chicago neighborhood, from January 2016 to December 2018. We focused on individuals using statins (n = 1044), angiotensin-converting enzyme inhibitors (ACEs)/angiotensin II receptor blockers (ARBs) (n = 1003), or noninsulin diabetes medications (NIDMs) (n = 692). We defined adherence as a proportion of days covered greater than 80% over 12-months. We examined the association between telepharmacy use and medication adherence using logistic regressions adjusted for demographics (age and sex) and index prescription characteristics (method of payment, e-prescription, 90-day supply).
Telepharmacy users were less adherent to statins (37.6% vs. 54.3%, adjusted odds ratio 0.54 [95% CI 0.38-0.76], P < 0.01) and ACEs/ARBs (41.4% vs, 56.5%, 0.61 [0.44-0.84], P < 0.01) than users of the traditional pharmacy. However, adherence to NIDMs was similar among users of the tele- and traditional pharmacies (65.5% vs. 60.1%, 1.47 [0.92-2.35], P = 0.11). Our findings were similar when we conducted a series of sensitivity analyses, including restricting our cohorts to those who only used their index pharmacy and analyzing cohorts of new rather than continuing users of these medications.
In this analysis, medication adherence was lower among users of telepharmacy than users of a traditional pharmacy in some but not all drug classes examined. Further research is needed to identify whether other interventions to improve adherence, such as longer hours of operation, at-home delivery, or 90-day supply, may be coupled with telepharmacies to increase their use in urban areas.
远程药房通过远程通信技术在远程药剂师的监督下在现场配药，被认为是改善药房关闭影响和提高药物获取途径的一种手段。
在城市社区中，通过远程药房和传统药房配药的个体之间，考察药物使用的依从性是否存在差异。
我们开展了一项回顾性队列研究，使用了 2016 年 1 月至 2018 年 12 月期间位于同一低收入芝加哥社区的一家传统药房和一家远程药房的配药记录。我们重点关注使用他汀类药物（n=1044）、血管紧张素转换酶抑制剂（ACEs）/血管紧张素 II 受体阻滞剂（ARBs）（n=1003）或非胰岛素类糖尿病药物（NIDMs）（n=692）的个体。我们将依从性定义为在 12 个月内，用药天数覆盖率超过 80%的比例。我们使用调整了人口统计学特征（年龄和性别）和索引处方特征（支付方式、电子处方、90 天供应量）的 logistic 回归，考察了远程药房使用与药物依从性之间的关系。
与传统药房使用者相比，远程药房使用者的他汀类药物（37.6% vs. 54.3%，调整后的比值比 0.54 [95% CI 0.38-0.76]，P<0.01）和 ACEs/ARBs（41.4% vs. 56.5%，0.61 [0.44-0.84]，P<0.01）的使用依从性更低。然而，远程和传统药房使用者的 NIDMs 药物使用依从性相似（65.5% vs. 60.1%，1.47 [0.92-2.35]，P=0.11）。在进行了一系列敏感性分析后，我们得到了类似的结果，包括将我们的队列限制在仅使用其索引药房的患者中，并分析这些药物的新使用者而不是持续使用者的队列。
在这项分析中，与传统药房使用者相比，远程药房使用者在一些但不是所有研究药物类别中的药物使用依从性更低。需要进一步研究以确定其他提高依从性的干预措施（如延长运营时间、上门配送或 90 天供应量）是否可以与远程药房结合使用，以增加它们在城市地区的使用。
