P3.A002: Analysis of Pediatric Mail Order Pharmacy Usage Throughout the COVID19 Pandemic

Background: Mail order pharmacies offer increased convenience, higher rates of patient compliance, and lower costs to both patients and the health care system. Further, studies have shown increased completion of prescriptions for patients with transportation obstacles, inflexible work hours, and limited English proficiency with mail order pharmacies but poor utilization by such populations. Overall utilization has been declining from 2005 to 2018. This study attempts to review the relationship between demographics and social needs of pediatric families and use of mail order pharmacies at a single institution.

Methods: The cross-sectional, retrospective design reviewed traditional in-person and mail order pharmacy prescription completion at an a midwestern academic medical center for children less than 18 years old from June 2020 to December 2022. Prescriptions completed outside pharmacies outside of the academic medical center were excluded. Demographic features and social needs that were significant at p < 0.1 from the univariate analysis were subjected to multivariate logistic regression analysis to obtain the adjusted odds ratio (OR) and 95% confidence interval (CI). A p-value of less than 0.05 was considered to be statistically significant.

Results: Demographic profile of population in 2020 can be found in table 1 while odds ratios are listed in table 2. In 2020,Mail order pharmacy prescription completion occur more frequently by families who identified as English speaking (OR of 3.61, 95% CI of 1.22-10.70, p-value of 0.02), and religious (OR of 2.38, 95% CI of 1.68-3.40, p-value of < 0.001). Less frequent use of this service is seen among patient who identified as non-white (OR of 0.31, 95% CI of 0.17-0.59, p-value of 0.002). Percentage of mail order pharmacy use increased from 2020 to 2022 as the COVID-19 pandemic progressed.

Conclusion: The study reiterated disparities in mail order pharmacy utilization for recognized vulnerable populations such as families with limited English proficiency and identifying as non-white despite benefit for use in such groups. The increased use of mail order pharmacy from 2020 to 2022 suggested greater comfort with non-traditional pharmacy services increased as the pandemic progressed despite relative easing of isolation restrictions. Finding means to engage vulnerable families in alternative care delivery methods remains a challenge and important priority for the health care system.