The practice of family pharmacists in managing polypharmacy for home-based elderly patients.

Abstract

Family Pharmaceutical Care (FPC) provides personalized, continuous pharmaceutical interventions and health education, creating a home-centered polypharmacy management framework for elderly patients under the supervision of family pharmacists. This study evaluates FPC's feasibility and impact, offering evidence for regional family pharmacist team building and care model development. This cohort study enrolled 123 elderly patients discharged between January 2024 and March 2025, divided per patient preference into control and observation groups, both for 6months. Quarterly follow-ups assessed clinical outcomes and implementation barriers. Using FPC achieved a net reduction in pharmaceutical expenditures of USD2,002.49 (RMB14,362.06) and demonstrated significantly lower hospitalization costs USD19,704.92 (RMB 141,325.80), and a 17.56% decrease in hospitalization frequency during the 6-month follow-up period compared to controls. The observation group achieved sustained glucose control (FPG 13%, 2hPG 17%, <i>P</i> < 0.001), BMI reduction (6.52%, <i>P</i> < 0.001), and blood pressure improvements (SBP/DBP: 6.4%/6.1%, <i>P</i> < 0.01). The control group showed better lipid improvements (LDL-c 22.49%, TC 15.00%, both <i>P</i> < 0.001). Both groups exhibited paradoxical HbA1c increases (observation vs control, -0.35% vs -0.90%). The glycemic and blood pressure target rate significantly improved, FPG (47.37% vs 29.82%), 2hPG (38.60% vs 22.81%), and blood pressure (35.09% vs 29.82%). While the target rate of the HbA1c initially demonstrated significant improvement at 3 months (36.84% vs 19.30%), this positive effect was not sustained to the study end. Combining FPC and pharmacy outpatient management with medical care is beneficial. Pharmacists can help patients solve their medication problems through standardized service models, reducing hospitalizations and medical expenses, while also improving the blood sugar, blood pressure, and blood lipid indicators of patients with chronic diseases.