Factors associated with the introduction of visiting-pharmacist services in older adults in Japan: A nested case-control study

AimTo investigate the factors associated with introducing visiting-pharmacist services for community-dwelling older adults in Japan.MethodsWe conducted a nested case-control study using claims data in a cohort from a city in Tokyo. Patients aged >= 65 years who received visiting-pharmacist services for the first time between April 2014 and March 2020 were considered case patients. A maximum of four controls to each case patient were randomly selected on the basis of sex, age, health insurance systems, and month-year. Medical and long-term care service usage and patient condition were assessed using claims data from the index and preceding months, along with long-term care needs certification data. Multivariable conditional logistic regression analysis was conducted to estimate the adjusted odds ratios with 95% confidence intervals for factors associated with visiting-pharmacist service introduction.ResultsA total of 22 949 participants (4591 cases and 18 358 controls) were included, with a median age of 85 years; 59.3% were women. The adjusted odds ratios (95% confidence intervals) of the three most related factors were 27.61 (23.98-31.80) for physicians' home visits, 5.83 (5.08-6.70) for hospitalization, and 4.97 (4.16-5.95) for designated-facility admission. Factors such as prescribing >= 10 medications, visiting nursing, and cancer were positively associated. In contrast, low household income and a high need for support due to cognitive function or disability were negatively associated.ConclusionsThis study provides insights into the introduction of visiting-pharmacist services for older adults in Japan. Geriatr Gerontol Int 2024; center dot center dot: center dot center dot-center dot center dot. This study examined the factors associated with introducing visiting-pharmacist services using claims data from a community-dwelling older population in Japan. Physicians' home visits, hospitalizations, and residential-facility admissions were strongly associated, and the findings contribute to a better understanding of the current situation regarding the introduction of visiting-pharmacist services. image