Title : Digital health transformed pharmacist-led chronic care
For the past five years CareLinker has been developing and implementing a cloud-based digital solution to assist pharmacists to provide chronic care of hypertension and diabetes at retail pharmacies in China. The solution includes tele-monitoring devices, a pharmacist-end App, a patient-end mini-program embedded in wechat which is the Chinese version of WhatsApp, and a cloud engine that runs five proprietary algorithms supporting disease risk assessment, personalized lifestyle intervention and medication guidance to pharmacists or patients. Over five million hypertensive and/or diabetic patients have received instore or tele-health services in more than 200 cities and we found both blood pressure (BP) and blood glucose (BG) levels were reduced. In the selected groups of patients who had complete health data and were hypertensive or diabetic at baseline, the average reduction of BP or BG was: SBP by 12 mmHg, DBP by 7 mmHg, FBG by 0.8 mM, and RBG by 3.2 mM. In addition, 54% of the comorbidity patients demonstrated controlled BP and/or BG. Further analysis of medication adherence measured by proportion of days covered (PDC) identified an average of 10% improvement on patients who were taking anti-hypertensive or anti-diabetic drugs when PDCs at baseline and the last-time were compared. The trend of adherence change peaked in the first two months by 15-20% and gradually returned to the baseline in 6-10 months. Taken together, we draw the conclusion that pharmacists are valuable resources in a close-loop digital healthcare setup to enhance community hypertension and diabetes control, and medication adherence improvement might be one of the underlying mechanisms leading to the observed health benefits.
Audience Take Away:
- Retail pharmacists equipped with digital health tools can effectively deliver chronic care.
- The digital health ecosystem centered on the drug stores can help design and conduct large population real world study.
- The vast amount of personal health data collected in time at pharmacies can facilitate the development of AI models that can profile and cluster patients to assist caregivers to deliver proactive and personalized intervention.
- Cloud-based medication adherence solution can not only improve adherence but also be used to monitor drug safety in real-time.