[PMID: 29070783 DOI: 10.3143/geriatrics.54.g3]

[Effect of a Family Pharmacist System on Medication Adherence of Patients with Dyslipidemia during a COVID-19 Epidemic]

The pharmacy pharmacist's function as a family pharmacist is expected to improve adherence to medication in patients suffering from chronic diseases, including dyslipidemia. This is true even in infectious disease epidemics. In this study, using anonymously processed receipt data from 700 insurance pharmacies in our group, we evaluated medication adherence in patients taking statin drugs before, during the first and second years of coronavirus disease 2019 (COVID-19) epidemic in terms of medication persistence and medication possession, and compared the results between the family pharmacist group (FP group) and non-family pharmacist group (NoFP group). The odds ratios of good medication adherence (medication persistence and medication possession) rates for the FP group relative to the NoFP group were 1.446 [95% confidence interval (CI): 1.210-1.727] in the pre-epidemic period, 1.428 (1.192-1.710) in the first year of the epidemic, and 1.270 (1.113-1.450) in the second year of the epidemic. The FP group was significantly higher in all time periods. Therefore, it is suggested that the family pharmacist function improves adherence to statins not only before but also during the COVID-19 epidemic.

Association of pharmacological treatments for hypertension, diabetes, and dyslipidemia with health checkup participation and identification of disease control factors among older adults in Tokyo, Japan

The Japanese government encourages older adults to participate in annual health checkups designed to detect lifestyle diseases such as hypertension, diabetes, and dyslipidemia. However, individuals who are already being treated for these diseases are unlikely to benefit from health checkup participation. This retrospective cohort study of older adults evaluated the associations of pharmacological treatments for these diseases with health checkup participation and identified the disease control factors among patients receiving treatments. Using medical claims data and health checkup data between September 2013 and August 2014 from 820,215 older adults aged ≥ 75 years residing in Tokyo, Japan, we examined the associations between pharmacological treatments and health checkup participation using binary logistic regression analysis. Next, patients receiving pharmacological treatments were categorized into intensive, moderate, or limited disease control based on their blood pressure, hemoglobin A1c levels, and lipid levels; multinomial logistic regression analyses were used to identify the disease control factors. The results showed that patients receiving pharmacological treatments were more likely (odds ratio: 1.374; P < 0.001) to participate in health checkups than patients not receiving treatments. Patients with intensive disease control were more likely to be aged ≥ 90 years and use home medical care than patients with moderate control. Our findings suggest that it may be beneficial to shift the focus of health checkups from simply identifying at-risk patients to also supporting disease management. Information obtained from databases that link medical claims and health checkup data may improve evaluations of disease control in older adults and help to streamline healthcare systems.

Era of geriatric medical challenges: Multimorbidity among older patients

The number of older adults is increasing worldwide, including in Asian countries. Various problems associated with medical care for older adults are being highlighted in aging societies. As the number of chronic diseases increases with age, older adults are more likely to have multiple chronic diseases simultaneously (multimorbidity). Multimorbidity results in poor health-related outcomes, leading to increased use and cost of healthcare. Above all, it leads to deterioration in older adults' quality of life. However, it is unclear whether any medical interventions are effective for multimorbidity, which means medical practitioners currently offer medical care "in the dark." It is therefore necessary for researchers and medical professionals involved in geriatric medicine to establish ways to manage multimorbidity among older adults. This means that the development of research in this field is essential. Geriatr Gerontol Int 2019; 19: 699-704.