Impact of a Digital Pharmacy on Medication Adherence, Clinical Outcomes, and Healthcare Utilization
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Authors
Derry, Tristan
Date
2024-09-13
Type
thesis
Language
eng
Keyword
Medication adherence , Primary health care , Digital pharmacy , Chronic disease
Alternative Title
Abstract
Introduction: Medication nonadherence is a critical concern to healthcare systems worldwide, and virtual interventions to improve medication adherence have become increasingly common. The main objective of this thesis was to evaluate the impact of a digital pharmacy on medication adherence, clinical outcomes, and healthcare utilization for those with chronic diseases. A secondary objective was to assess the relationship between usability of the digital pharmacy and medication adherence.
Methods: At baseline, demographic and prescription data were obtained, and medication adherence was assessed with the Adherence to Refills and Medications Scale. Medication adherence was reassessed after a 3-month follow-up, and the usability of the digital pharmacy was examined with the mHealth App Usability Questionnaire. Clinical outcomes (Hemoglobin A1c, systolic and diastolic blood pressure) were obtained from primary care administrative data for before and after the study period. Healthcare utilization (emergency department and hospital outpatient visits) was obtained from the Shared Health Integrated Information Portal for 6-month periods before and after the study period. Medication adherence, clinical outcomes, and healthcare utilization were each fit with a generalized linear mixed model with identified confounding variables and an interaction between group and time. The relationship between usability and change in medication adherence was examined with the generalized linear model.
Results: A total of 59 participants were recruited from two primary care sites, with 14 participants using the digital pharmacy and 45 participants serving as comparators. The groups were comparable in terms of demographic, prescription, and baseline outcome data. Medication adherence significantly increased for those who used the digital pharmacy compared to those who did not (B = 1.66, 95% CI: 0.09, 3.23). Clinical outcomes improved, and healthcare utilization decreased, but these differences were not significant. Usability was not associated with changes in medication adherence.
Conclusion: The use of a digital pharmacy appears to be associated with improved medication adherence and clinical outcomes, and decreased healthcare utilization. Future studies with greater power will need to be conducted to substantiate these effects.
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Queen's University's Thesis/Dissertation Non-Exclusive License for Deposit to QSpace and Library and Archives Canada
ProQuest PhD and Master's Theses International Dissemination Agreement
Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.
Queen's University's Thesis/Dissertation Non-Exclusive License for Deposit to QSpace and Library and Archives Canada
ProQuest PhD and Master's Theses International Dissemination Agreement
Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.