Objective: Message-based medication follow-up applications are increasingly used in community pharmacies, but age-stratified differences in use and alert characteristics remain insufficiently examined. We compared the use of a follow-up application between non-elderly and elderly patients and clarified the characteristics of alerts and app-triggered tracing reports (TRs).
Design: Retrospective observational study at a single community pharmacy.
Methods: Patients who used the Pocket Musubi® application at a community pharmacy in Japan from April to October 2025 were included. Patient-level outcomes (recipients, responders, alert patients, pharmacist actions) and message-level outcomes (questions, responses, alerts, pharmacist actions) were compared between non-elderly (< 65 years) and elderly (≥ 65 years) patients. Alerts categorized into five types were compared. App-triggered TRs were reviewed for alert content, medications, and physician interventions.
Results: Among pharmacy visitors during the study period, questions were sent to 206 non-elderly and 155 elderly patients registered to the application. In patient-level analyses, the elderly group showed a higher response proportion (59.2% vs. 69.0%; p = 0.07) and a significantly higher alert proportion (50.0% vs. 64.5%; p = 0.04). In message-level analyses, 2,135 and 2,316 question messages were sent to non-elderly and elderly patients, respectively, and the elderly group showed a higher response proportion (38.5% vs. 43.1%; p < 0.01) and a higher alert proportion (19.1% vs. 23.9%; p = 0.02). "Adverse effects" was the most common alert in both groups; however, "appropriate use" was more frequent in non-elderly patients, whereas "lifestyle guidance" was more frequent in elderly patients (p < 0.01). Six app-triggered TRs were identified, mainly involving issues that patients are less aware of (e.g., inhalation errors, minor health changes, blood pressure variation). Four TRs resulted in physician interventions.
Conclusion: The follow-up application was used effectively across age groups. Pharmacist follow-up using the app supported early detection of clinical changes and timely communication with physicians.
