Department of Pharmaceutical Sciences, Harrisburg University of Science and Technology, Harrisburg, Pennsylvania, USA.
RxLive, Inc., St. Petersburg, Florida, USA.
Telemed J E Health. 2024 Feb;30(2):556-562. doi: 10.1089/tmj.2023.0094. Epub 2023 Aug 7.
Adherence to a medication regimen is defined as taking the medication as directed by the prescriber. Adherence is critical to achieve the desired therapeutic outcomes. Medication adherence has not been examined in large outpatient populations since the onset of the COVID-19 pandemic. A novel outpatient value-based pharmacy system (VPS) was used to collect adherence data from a large, outpatient population. The aim of this descriptive study was to analyze the reasons, medication classes, and diagnoses associated with nonadherence. Telepharmacist-documented adherence data from a large ( = 6,479) outpatient population that received remote consultation during the COVID-19 pandemic (August 1, 2020-November 28, 2022) were considered for this study. The adherence data were compiled within the VPS. The overall rate of patients reporting at least one incident of nonadherence to their medication regimens was 21.5%. Medications used to treat hypertension, type 2 diabetes, and hyperlipidemia were least adhered to. Statins, beta-2 agonists, and corticosteroids were least adhered to. The most common reasons for nonadherence included knowledge gaps regarding therapy, forgetfulness, and side effects. This represents the first descriptive analyses of adherence metrics in a large outpatient population during the COVID-19 pandemic. Polypharmacy, prevalence of diagnosis, and medication side effect profile may have contributed to the results observed. This study demonstrates the ability of a VPS to document key data to better inform the health care team. Elucidating adherence metrics in such populations may allow pharmacists and prescribers to identify subpopulations that require further education and management.
遵医嘱服药是指按照医生的指示服药。为了达到预期的治疗效果，遵医嘱服药至关重要。自 COVID-19 大流行以来，尚未在大型门诊人群中检查过药物依从性。一种新的基于价值的门诊药房系统 (VPS) 用于从大型门诊人群中收集依从性数据。本描述性研究的目的是分析不遵医嘱的原因、药物类别和诊断。
本研究考虑了在 COVID-19 大流行期间（2020 年 8 月 1 日至 2022 年 11 月 28 日）接受远程咨询的大型（ = 6,479）门诊人群中，由电话药剂师记录的依从性数据。依从性数据在 VPS 中汇编。
报告至少一次不遵守其药物治疗方案的患者的总体比例为 21.5%。用于治疗高血压、2 型糖尿病和高血脂的药物依从性最低。他汀类药物、β2 激动剂和皮质类固醇的依从性最低。不遵医嘱的最常见原因包括对治疗的知识差距、健忘和副作用。
这代表了 COVID-19 大流行期间在大型门诊人群中对依从性指标的首次描述性分析。多药治疗、诊断的普遍存在和药物副作用特征可能促成了观察到的结果。这项研究表明了 VPS 记录关键数据以更好地为医疗保健团队提供信息的能力。阐明此类人群中的依从性指标可能使药剂师和处方者能够识别需要进一步教育和管理的亚人群。
