Analysis of Pharmacist Interventions during Remote Accompaniment to Physician’s Home Visits in a Medically Underserved Area: A Comparative Study with Conventional In-Person Practice

Abstract

Participation of pharmacists during physicians’ home visits is effective in home healthcare. However, substantial practical barriers exist in regions where medical resources are unevenly distributed. This study sought to clarify the effectiveness and limitations of a hybrid online model—where only the pharmacist joins remotely—by comparing it with conventional on-site accompaniment. We retrospectively reviewed all pharmacist accompaniments to physicians’ home visits at an older adult care facility in Chitose, Hokkaido, from April 2022 to March 2024. Pharmacist interventions that resulted in a claim for preventing medication-related problems were identified, and the nature of these interventions and patient outcomes were compared between the online and in-person groups. Of the total 1,986 visits, 138 involved online accompaniment and 1,848 involved on-site accompaniment. The rate of proactive interventions leading to prescription modification was similar in the descriptive comparison between the online and on-site groups (7.2％ vs 5.8％, respectively). The proportion of patients whose condition improved following these interventions was also similar in the descriptive analysis (50.0％ vs 49.5％, respectively). No patient deterioration was observed in the online group, Qualitative analysis revealed that all online interventions were based on objective clinical data or patient narratives, whereas interventions requiring direct physical assessment were confirmed only during on-site visits. In this exploratory descriptive study, no marked differences were observed in the proportion of prescription-modifying interventions or short-term clinical outcomes. These findings suggest that hybrid online accompaniment may represent a feasible alternative in settings where in-person participation is difficult, although larger comparative studies are required.