Effects of a Family Pharmacist System on Medication Adherence in Patients with Diabetes during the COVID-19 Epidemic

Abstract

Objective: Maintaining and improving medication adherence are vital for the treatment of type 2 diabetes. Centralized administration of medication by a family pharmacist is expected to improve medication adherence, even during infectious disease epidemics. This study aimed to determine the effects of the family pharmacist system on medication adherence in patients with type 2 diabetes before and after the COVID-19 epidemic in Japan. Methods: Using anonymously processed receipt data from 628 insurance pharmacies operated by our group, three levels of medication persistence (gap, interruption, persistence) and medication possession (poor, good, excessive) were evaluated in patients receiving dipeptidyl peptidase (DPP)-4 inhibitors and metformin before the COVID-19 epidemic (pre-epidemic), and during the first and second years of the epidemic (epidemic years 1 and 2, respectively) The results were compared between the family pharmacist and non-family pharmacist groups. Results: The odds ratios for the proportion of patients with good medication adherence (medication persistence: persistence, medication possession: good) in the family pharmacist group relative to that in the non-family pharmacist group were significant in the pre-epidemic period (1.612) but not in epidemic years 1 (1.353) or 2 (1.304). Conclusion: Our results suggest that the family pharmacist system improves adherence to DPP-4 inhibitors and metformin; however, its effectiveness decreased during the COVID-19 epidemic. Therefore, to improve medication adherence even during infectious disease epidemics, we believe it is important to create an environment in which family pharmacists can perform their roles not only in person but also remotely.