Novel remote electronic medication supply model for opioid-dependent outpatients with polypharmacy-first long-term case study

被引:1
作者
Allemann, Samuel S. [1 ]
Duersteler, Kenneth M. [2 ]
Strasser, Johannes [2 ]
Vogel, Marc [2 ]
Stoeckle, Marcel [3 ]
Hersberger, Kurt E. [1 ]
Arnet, Isabelle [1 ]
机构
[1] Univ Basel, Pharmaceut Care Res Grp, Pharmaceut Sci, Basel, Switzerland
[2] Univ Basel, Div Addict Disorders, Psychiat Hosp, Basel, Switzerland
[3] Univ Hosp Basel, Dept Infect Dis, Basel, Switzerland
关键词
Medication adherence; Medication management aid; Interprofessional collaboration; Substance use disorders; Old age; DISPENSING DEVICE; ADHERENCE; IMPACT; RISK;
D O I
10.1186/s12954-017-0182-x
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Background: Patients with substance use disorders grow older thanks to effective treatments. Together with a high prevalence of comorbidities, psychological problems, and low social support, these patients are at high risk for medication non-adherence. Established treatment facilities face challenges to accommodate these complex patients within their setting. Electronic medication management aids (e-MMAs) might be appropriate to simultaneously monitor and improve adherence for these patients. Case presentation: We report the first long-term experiences with a novel remote electronic medication supply model for two opioid-dependent patients with HIV. John (beginning dementia, 52 years, 6 tablets daily at 12 am) and Mary (frequent drug holidays, 48 years, 5-6 tablets daily at 8 pm) suffered from disease progression due to non-adherence. We electronically monitored adherence and clinical outcomes during 659 (John) and 953 (Mary) days between July 2013 and April 2016. Both patients retrieved over 90% of the pouches within 75 min of the scheduled time. Technical problems occurred in 4% (John) and 7.2% (Mary) of retrievals, but on-site support was seldom required. Viral loads fell below detection limits during the entire observation period. Conclusions: Continuous medication supply and persistence with treatment of over 1.7 years, timing adherence of more than 90%, and suppressed HIV viral load are first results supporting the feasibility of the novel supply model for patients on opioid-assisted treatment and polypharmacy.
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页数:8
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