Ida Ayu Alit Widhiartini, I Komang Aan Adi Ricardo, Ni Putu Wika Pebrianti, Putu Yudha Kartika Pratama

Home Pharmacy Care Services in Improving Medication Adherence in Diabetic and Hypertensive Patients: A Systematic Review on Ethics and Regulatory

Introduction

Home pharmacy care services in improving medication adherence in diabetic and hypertensive patients: a systematic review on ethics and regulatory . Systematic review on home pharmacy care services for diabetic and hypertensive patients. Explores how it improves medication adherence and addresses ethical & regulatory challenges.

Abstract

Home pharmacy care is a part of community pharmacy service that is critical in improving patient adherence, which is a significant challenge in managing chronic diseases. One approach that can help overcome this problem is the practice of home pharmacy care. The current study aimed to evaluate the role of home pharmacy care interventions can enhance medication adherence among diabetic and hypertensive patients and to examine the ethical and regulatory aspects associated with its implementation. A systematic review was conducted based on the PRISMA guidelines, using the keywords “home pharmacy care” AND (diabetes mellitus OR hypertension) AND kepatuhan, home pharmacy care AND diabetes mellitus AND (adherence OR compliance), home pharmacy care AND hypertension AND (adherence OR compliance) on Google Scholar and PubMed databases with a search time limit from January 2015 to May 2025. The ethical and regulatory analysis was conducted by reviewing secondary literature regulating home pharmacy care and professional codes of ethics. Out of a total of 290 identified articles, only 10 met the inclusion criteria for further analysis. Based on the ten reviewed articles, it was stated that home pharmacy care interventions can enhance medication adherence among patients with diabetes mellitus and hypertension. However, the implementation of this service faces challenges, such as ethical concerns and regulatory limitations. The development of comprehensive regulations and consistent application of the code of ethics are expected to strengthen legal protection for pharmacists and improve the quality of home pharmacy care services.

Review

This systematic review addresses the crucial role of home pharmacy care in enhancing medication adherence among diabetic and hypertensive patients. Utilizing PRISMA guidelines, the authors rigorously searched Google Scholar and PubMed for relevant studies published between January 2015 and May 2025. Despite an initial identification of 290 articles, only 10 met the stringent inclusion criteria for analysis. The primary finding of the review firmly supports that home pharmacy care interventions can indeed improve medication adherence in these patient populations, highlighting its potential as a valuable component of chronic disease management. Beyond the clinical effectiveness, the study commendably delves into the complex ethical and regulatory landscape surrounding home pharmacy care. The analysis for this aspect involved reviewing secondary literature on regulations and professional codes of ethics. This exploration revealed that despite the clear benefits, the practical implementation of these services is significantly hindered by existing ethical concerns and regulatory limitations. The review concludes by emphasizing the imperative for developing comprehensive regulations and ensuring the consistent application of ethical codes to not only protect pharmacists but also to elevate the quality of home pharmacy care. While the systematic review offers a timely and relevant contribution, a few methodological aspects could be further elucidated. The relatively small number of studies (10 out of 290 initial hits) meeting inclusion criteria for the adherence analysis suggests a potential limitation in the breadth of evidence, and greater detail on the characteristics and quality of these 10 studies would strengthen the certainty of the findings. Furthermore, the abstract's mention of a search period extending to "May 2025" appears to be a typographical error that should be corrected. For the ethical and regulatory analysis, a more detailed description of the systematicity in selecting "secondary literature" and the specific geographical scope of these regulations would enhance the robustness and generalizability of these particular conclusions. Despite these points, the study effectively brings attention to a critical area of healthcare service and lays important groundwork for future policy development and practice guidelines.

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