Background and Importance Biologic therapies (BT) used in psoriasis are hospital restricted dispensation medications. Lately, telepharmacy procedures, including non-face-to-face dispensation had become more common.
Aim and Objectives To analyse if a telepharmacy programme (dispensation through community pharmacies (DTCP) and follow-up pharmacist-teleconsultations) can improve adherence and clinical outcomes in a cohort of patients with psoriasis receiving BT.
Material and Methods Patients with psoriasis on stable BT were offered to enter a telepharmacy programme in February 2020 in the Pharmacy Outpatients Area of a tertiary hospital. The programme consisted in DTCP accompanied with follow-up pharmacist teleconsultations.
Patients included in the study must had been in stable treatment for at least one year before entering this programme (‘previous period’, February 2019-February 2020) and stay for 6 months (‘later period’).
Adherence (Medication Possession Ratio) and clinical variables (Body Surface Area (BSA) and Psoriasis Area and Severity Index (PASI)) were assessed during both periods. In the ‘later period’ adherence to BT dispensed through community pharmacies was confirmed with patients by pharmacist teleconsultations.
Differences between adherence and clinical outcomes were evaluated in both periods as well as variables associated with an improvement in adherence. Quantitative data expressed as frequency and qualitative data as median (IQR).
Results Of 221 patients, 99(44,8%) accepted to enter the programme. Of them, 45 (45,5%) were excluded: change of treatment 32 (14,5%), BT for less than 1 year 12 (5,4%) and loss of follow-up 7(3,2%).
Baseline characteristics of the 54 included patients: 31 (59,6%) male, age 53 (44–63) years, 32 (61.5%) BT-naïve. 5,7 (2,9–10,1) years on BT.
BT: adalimumab 15 (28,8%), secukinumab 12 (23,1%), ixekizumab 10 (19,2%), others 17 (31,5%).
Adherence was 92,3% (IQR:78,0%-97,9%) in the previous period and 95% (IC95%:88,3%-100%) in the later period with a significant increasement (p=0,003).
The median increasement in adherence was 4% (IQR2%-15,7%) in 29 (55,8%) patients. Increasement in adherence was greater in female patients (53,3% vs 22,7%, p=0,044). No significant differences observed when comparing PASI values,% patients with PASI<2 and BSA between both periods.
Conclusion and Relevance Telepharmacy programs (dispensation through community pharmacies with teleconsultations) may improve adherence to biologic therapies in patients with psoriasis.
We need to evaluate a larger number of patients and for a long period to analyse whether this increasement in adherence is associated with better outcomes.
Conflict of Interest No conflict of interest
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.