Implications of COVID-19 Infection on Medication Adherence with Chronic Therapies in Italy: A Proposed Observational Investigation by the Fail-to-Refill Project.
Implications of COVID-19 Infection on Medication Adherence with Chronic Therapies in Italy: A Proposed Observational Investigation by the Fail-to-Refill Project.
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DOI：
10.2147/rmhp.s265264
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发表时间：
2020
影响因子：
3.5
通讯作者：
Network Health-DB
中科院分区：
文献类型：
--
作者：
Degli Esposti L;Buda S;Nappi C;Paoli D;Perrone V;Network Health-DB
药物依从性差导致临床结果恶化并增加医疗保健成本，特别是在慢性疾病的背景下。新型COVID-19感染的影响以及为应对疫情而采取的措施进一步增加了对药物依从性的担忧。患有慢性病的患者，其中许多是老年人，强烈建议留在家中，避免与家人接触，即使是家庭成员，他们经常为定期使用治疗提供支持。此外，动员卫生人员到COVID-19感染的前线可能会限制获得医疗服务。在Health-DB项目中，再灌注失败监测系统旨在评价意大利临床实践环境中缺乏长期治疗依从性的情况。考虑到最后一次处方的日期和剂量覆盖范围，确定了上个月因慢性治疗而应重新填写该处方的所有患者，并验证了他们是否进行了重新填写。拟议的未来分析将基于所涉及的意大利地方卫生单位当前行政流程之间的数据联系，从感染开始每月进行一次，并将“2019冠状病毒病后”的结果与“2019冠状病毒病前”的结果进行比较，对接受慢性治疗的患者计算过去三年的结果。本文提供的初步数据显示，在降脂和生物疗法封锁的几个月内，再填充失败的趋势有所增加。COVID-19前的趋势与COVID-19后的趋势在未来几个月的比较将有助于估计与COVID-19真正相关的未能补充的百分比以及所采取的措施。识别出不续开处方的患者，使医疗保健专业人员能够采取行动，及时纠正缺乏依从性的情况，从而减少相关的负面结果。
Poor medication adherence leads to worsening of clinical outcomes and increases healthcare costs, especially in the context of chronic conditions. The effects of new COVID-19 infection and the measures taken in response to the outbreak are further increasing the concerns about medication adherence. Patients with chronic diseases, many of whom are older adults, have been strongly recommended to stay at home and avoid social contacts even with family members, who often provide support for regular use of therapies. Moreover, the mobilization of health personnel to the frontline of the COVID-19 infection could limit access to healthcare services. Within the Health-DB project, the Fail-To-Refill monitoring system was designed to evaluate the lack of adherence to chronic therapies in Italian clinical practice settings. Considering the date and dose coverage of last prescription, all patients due to refill this prescription for a chronic therapy in the last month were identified, and it was verified if they had the refill. The proposed future analysis, based on the data linkage between the current administrative flows of the Italian Local Health Units involved, will be carried out on a monthly basis from the beginning of the infection, and the “post-Covid-19” results will be compared with “pre-COVID-19” results, calculated for the last three years for patients with chronic therapies. Preliminary data herein presented showed a trend of increased failed refill during the months of lockdown for lipid-lowering and biologic therapies. The pre-COVID-19 trend compared to that of post-COVID-19 in the next months will be useful to estimate the percentage of failure to refill truly related to COVID-19 and on the measures adopted. The identification of patients that do not refill their prescriptions allows healthcare professionals to put in place actions aimed to promptly correct the lack of adherence, thus reducing the associated negative outcomes.