Integrated Internet-Based Pharmaceutical Care and Its Association with Clinical Outcomes and Medication Adherence in Older Adults with Multimorbidity: A Prospective Observational Study

Objective: To compare clinical outcomes, quality of life (QoL), medication behaviors, and readmission risk between older adults with multimorbidity receiving integrated Internet-based pharmaceutical care and those receiving conventional pharmaceutical care. Methods: This prospective observational study enrolled 196 older adults with multimorbidity who received either conventional or integrated Internet-based pharmaceutical care according to the service model in routine practice. After 6 months, BG and BP control rates, hospitalization rates, and patient satisfaction were compared. Frailty, health-related quality of life, medication self-management, and adherence were assessed using the FRAIL scale, EQ-5D/EQ-VAS, SEAMS, and ARMS-12, respectively. Logistic regression was used to examine the association between care model and 12-month readmission. Results: At the 6-month follow-up, the integrated Internet-based pharmaceutical care group had significantly higher BG and BP control rates and patient satisfaction than the conventional care group (P < 0.05). The integrated Internet-based care group also had lower FRAIL scores and higher EQ-5D and EQ-VAS scores. SEAMS scores were significantly higher, and ARMS scores were significantly lower in the Internet-based care group (P < 0.001). The integrated Internet-based pharmaceutical care model was significantly associated with a lower risk of 12-month readmission (OR = 0.424, 95% CI: 0.203– 0.884, P = 0.022). Conclusion: Integrated Internet-based pharmaceutical care was associated with favorable medication-related and clinical outcomes in older adults with multimorbidity. Further studies are needed to confirm these findings and clarify their generalizability. Keywords: older adults, multimorbidity, integrated Internet-based pharmaceutical care, readmission, medication adherence, medication self-management