節薬バッグを活用した残薬管理の服薬アドヒアランスに与える影響

抄録

Pharmacists are expected to help reduce increasing healthcare costs. This study assessed the effects of pharmacists at community pharmacies checking for unused prescribed medications using a bag in which patients put medications (Setsuyaku Bag). We examined whether this check improved medication adherence and also measured the costs of the unused medications.

Patients aged ≥ 20 years who brought the bag to community pharmacies were followed-up for 6 months. They took the bag to pharmacies if they had unused medications including those recently prescribed. Medication adherence scores at the first visit and after 6 months were assessed by patients (good 0–bad 4) and by pharmacists (good 1–bad 4). Changes in scores were analyzed using paired t-tests. Costs of unused medications were calculated, grouped as reused, saved, or discarded.

The patient adherence score for 73 patients (mean age 71.3 years) decreased from a mean of 1.8, SE 0.1 at the first visit to 0.8, 0.1 at the 6-month visit (P < 0.001). The pharmacist adherence score also decreased over this period from a mean of 2.4, SE 0.1 to 1.5, 0.8 (P < 0.001). The mean cost of total unused medications during the 6-month per person was 9,962 yen: reused 6,523 yen (65.5％), saved 1,506 yen (15.1％), and discarded 1,933 yen (19.4％).

Pharmacists' checkup for unused medications using a Setsuyaku Bag was likely to be effective for improving medication adherence, indicating that pharmacists can contribute indirectly to reducing healthcare costs through medication adherence and directly by lowering medication costs.