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Implications of COVID-19 Infection on Medication Adherence with Chronic Therapies in Italy: A Proposed Observational
Luca Degli Esposti1, Stefano Buda1, Carmela Nappi1
1CliCon S.r.l. - Health, Economics & Outcome Research, Ravenna, Italy.
Insights
Poor medication adherence, especially for chronic conditions, worsened during COVID-19 lockdowns. A new monitoring system identified increased failed prescription refills for lipid-lowering and biologic therapies, highlighting the need for interventions.
Area of Science:
- Health Economics
- Public Health
- Pharmacoeconomics
Background:
- Poor medication adherence negatively impacts clinical outcomes and escalates healthcare costs, particularly for chronic disease management.
- The COVID-19 pandemic and associated public health measures have exacerbated concerns regarding medication adherence, especially for elderly patients with chronic conditions who are advised to isolate.
- Disruptions in healthcare services due to health personnel mobilization for COVID-19 response may further limit patient access to necessary therapies.
Purpose of the Study:
- To introduce the Fail-To-Refill monitoring system developed within the Health-DB project to assess chronic therapy non-adherence in Italian clinical settings.
- To analyze the impact of the COVID-19 pandemic on medication adherence by comparing pre- and post-lockdown refill data.
- To identify patients at risk of non-adherence to enable timely interventions and mitigate negative health outcomes.
Main Methods:
- The Fail-To-Refill system identifies patients due for chronic therapy refills based on prescription dates and dosage coverage.
- It verifies whether these patients have successfully refilled their prescriptions within the last month.
- Future analysis will involve data linkage with Italian Local Health Unit administrative data for monthly tracking and comparison of pre- and post-COVID-19 adherence trends.
Main Results:
- Preliminary data indicate a trend of increased failed prescription refills during the COVID-19 lockdown periods, specifically for lipid-lowering and biologic therapies.
- This suggests a tangible impact of the pandemic and associated measures on medication adherence for certain chronic conditions.
Conclusions:
- The Fail-To-Refill system provides a valuable tool for monitoring medication adherence in real-world clinical practice.
- Understanding the extent of failed refills related to COVID-19 is crucial for developing targeted interventions to support patient adherence.
- Prompt identification and intervention for non-adherent patients can help reduce adverse clinical outcomes and healthcare costs.
Abstract:
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.
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