Evaluation of a Community Pharmacist-Led Intervention Program for Early Detection of Gastrointestinal Adverse Events of Dipeptidyl Peptidase-4 Inhibitors: A Multicenter, Non-Randomized Comparative Study.

Abstract

In this multicenter, nonrandomised comparative study, we evaluated the potential effectiveness of a program to promote the safe use of dipeptidyl peptidase-4 (DPP-4) inhibitors led by community pharmacists. The program facilitated early detection of gastrointestinal adverse events (GIAEs) in patients newly prescribed DPP-4 inhibitors and facilitated timely communication with physicians. Community pharmacists reviewed patient conditions and provided relevant information to physicians as needed. GIAE monitoring based on the program was conducted in 35 patients at 10 pharmacies in Japan (intervention group) between March and August 2024. The proportion of pharmacist interventions was compared with that in 451 patients from March to August 2023, before program implementation (baseline cohort). The primary outcome, pharmacist intervention rate, was significantly higher in the intervention group (5 out of 35 patients, 14.3%) than in the baseline cohort (0 out of 451 patients, 0.0%) (p < 0.001). GIAEs were identified in 13 out of 35 patients (37.1%) in the intervention group; information for five patients (14.3%) was shared with physicians, resulting in discontinuation of the DPP-4 inhibitor in one patient and addition of supportive therapy in others. Most GIAEs occurred within the first 1-2 weeks of therapy, highlighting the need for early intervention. Thus, proactive involvement of community pharmacists may improve the care process in these cases and contribute to healthcare coordination and diabetes care quality.