Mixed-Methods Study of Nirmatrelvir/Ritonavir Treatment for Mild COVID-19 in an Outpatient Setting in China

Background: Although numerous studies have investigated the efficacy and side effects of nirmatrelvir/ritonavir tablets (Paxlovid) for treating moderate and severe coronavirus disease 2019 , studies on the real-world medication management of outpatients with mild COVID-19 remain limited. Methods:The present observational study employed the SPIDER framework to evaluate the standard treatment of using Paxlovid tablets in 33 mild COVID-19 outpatients who visited Beijing United Family Hospital and Clinic from August 2023 to April 2024.Body temperature, antigen test results, and symptom resolution were recorded by the patients themselves.Semi-structured follow-up telephone interviews were performed by pharmacists on days 6 and 17 to collect medication information, including the patients' medication adherence.Results: Among the 33 patients, 29 completed at least one follow-up interview and 23 completed the standard treatment regimen.The median time from symptom onset to the first negative antigen test was 4 days.The adverse reactions were generally mild, with notably higher incidence rates of dysgeusia and diarrhea.Treatment was discontinued in six patients due to clinical improvement and/or adverse drug effects. Conclusion:The present study highlights the importance of addressing the factors for treatment discontinuation to enhance treatment adherence and confirms the feasibility of the standard treatment in outpatient populations with mild COVID-19 symptoms.Furthermore, follow-up telephone interviews conducted by pharmacists can effectively support outpatient medication management.Our study findings will further advance our understanding of the real-world administration of Paxlovid, also exploring strategies to facilitate pharmacist engagement to optimize outpatient care.