TELEPHARMACY AND MEDICATION ADHERENCE IN URBAN AREAS

ABSTRACT Background Pharmacy closures are increasingly common in low-income, urban areas and contribute to nonadherence to prescription medications. Telepharmacies, which dispense medications on-site under the supervision of an off-site pharmacist using telecommunication technologies, have been proposed as a means to ameliorate the impact of pharmacy closures and improve access to medications. Objectives To examine whether adherence varies among individuals filling prescription medications through a telepharmacy versus a traditional pharmacy in an urban neighborhood. Methods We conducted a retrospective cohort study using dispensing records of a traditional and telepharmacy, located in the same low-income Chicago neighborhood, from January 2016 to December 2018. We focused on individuals using statins (n=1,044), angiotensin-converting enzyme inhibitors (ACE)/ angiotensin II receptor blockers (ARB) (n=1,003), or non-insulin diabetes medications (NIDM) (n=692). We defined adherence as a proportion of days covered (PDC) ≥80% over 12-months. We examined the association between telepharmacy use and medication adherence using logistic regressions adjusted for demographic (age and gender) and index prescription characteristics (method of payment, e-prescription, 90-day supply). Results Telepharmacy users were less adherent to statins (37.6% vs 54.3%, adjusted odds ratio [aOR] 0.54 [95% confidence interval [CI]: 0.38-0.76], p Conclusion In this analysis, medication adherence was lower among users of telepharmacy as compared with a traditional pharmacy in some, but not all drug classes examined. Further research is needed to identify whether other interventions to improve adherence, such as longer hours of operation, at-home delivery, or 90-day supply, may be coupled with telepharmacies to increase their utility in urban areas.