Success of a sustained pharmaceutical care service with electronic adherence monitoring in patient with diabetes over 12 months

Abstract

SUMMARYWe report on the first polypharmacy adherence monitoring over 371 days, integrated into a pharmaceutical care service (counselling, electronic multidrug punch cards, feedback on recent electronic records) for a 65-year-old man with diabetes after hospital discharge. The initial daily regimen of four times per day with 15 pills daily changed after 79 days into a daily regimen of two times per day with 9 pills daily for the next 292 days. The patient removed all medication from the multidrug punch cards (taking adherence 100%) and had 96.9% correct dosing intervals (timing adherence). The 57 evening doses showed the least variation in intake times at 17 h 45 min±8 min. Over the observation year, the patient was clinically stable. He was very satisfied with the multidrug punch card and the feedback on electronic records. In conclusion, long-term monitoring of polypharmacy was associated with the benefit of successful disease management. BACKGROUND

Inclusion of Older Adults in Digital Health Technologies to Support Hospital-to-Home Transitions: Secondary Analysis of a Rapid Review and Equity-Informed Recommendations

“…Multimedia Appendix 1 shows the distribution of studies based on location. In addition, of 34 studies, 1 (n=1, 3%) study used qualitative methodology [ 111 ], 1 (n=1, 3%) study was a report [ 98 ], and another used a case study design (n=1, 3%) [ 81 ]. A total of 9% (n=3) of studies used a mixed methods methodology [ 3 , 87 , 96 ], whereas the remaining studies (28/34, 82%) used a quantitative methodological approach.…”

“…Briefly, web-based, tablet, and mobile app tools are the most common means of delivering digital interventions [ 3 , 83 - 94 , 100 - 103 , 105 - 108 , 110 , 111 ]. Electronic health records and databases [ 79 , 81 , 95 , 97 , 98 , 102 , 104 ] have been widely used for digital innovation. The use of wearable body sensors or devices [ 80 , 99 , 107 ], web-based chatting platforms [ 82 ], and automated emails [ 109 ] were less common.…”

“…The focus of digital health interventions varied. For example, some were related to medication reconciliation [ 79 , 81 , 97 , 104 ], whereas others aimed at providing education (eg, about rehabilitative exercises), internet-based care, and resources [ 83 , 86 , 89 , 92 , 94 , 96 , 100 , 104 - 106 , 111 ] and improved communication and care coordination with older adults’ care providers [ 3 , 82 , 91 , 104 , 108 ]. A total of 2 interventions aimed to improve communication processes among health care providers regarding discharge processes and care plans [ 93 , 109 ].…”

“…Justifications for maximum ages were not provided. A total of 7 studies did not report on their targeted age but instead referred to geriatric patients [ 81 , 83 , 101 , 102 , 109 , 110 ] or “elders” [ 98 ]. Multimedia Appendix 3 [ 3 , 83 - 94 , 100 - 103 , 105 - 108 , 110 , 111 ] outlines the targeted populations of the included studies.…”

Successful withdrawal from high-dose benzodiazepine in a young patient through electronic monitoring of polypharmacy: a case report in an ambulatory setting

“…In a prior study, patients reported that the visualization of the electronically recorded medicine intake that was used during the feedback sessions helped them to gain self confidence. 25 We present an illustrative case of withdrawal from high-dose BZDs with electronic monitoring of polypharmacy and corresponding feedback in an outpatient setting using multiprofessional team care. This report does not require ethics approval according to Swiss law (declaration of good standing).…”