Is Shelter-in-Place Policy Related to Mail Order Pharmacy Use and Racial/Ethnic Disparities for Patients With Diabetes?

Effective management of diabetes during the coronavirus disease 2019 (COVID-19) pandemic is critical given that hyperglycemia is both a risk factor for infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been associated with poorer outcomes for those infected (1). Unfortunately, inadequate diabetes self-management due to medication nonadherence is prevalent among patients with diabetes and is a major contributor to poor diabetes outcomes (2,3). Research suggests that mail order pharmacy (MOP) use can improve medication adherence (3). However, there is little data on how the COVID-19 pandemic is related to MOP use. Regrettably, racial/ethnic minority patients with diabetes have poorer medication adherence than White patients, and research shows marked disparities among racial/ethnic minorities in SARS-CoV-2 infection rates and outcomes, but little is known about racial/ethnic differences in MOP use during the COVID-19 pandemic (3,4). The objectives of our study were to 1 ) assess the association between the COVID-19 pandemic shelter-in-place order and MOP use and 2 ) examine these associations by patient race/ethnicity. We conducted a retrospective cohort study using a cohort from a randomized encouragement trial conducted in 2017–2018 at Kaiser Permanente Northern California (KPNC), the Encouraging Mail Order Pharmacy Use to Improve Outcomes and Reduce Disparities …