Leveraging telecommuting pharmacists in the post-COVID-19 world

Staff Experiences With Remote Work in a Comprehensive Cancer Center During the COVID-19 Pandemic and Recommendations for Long-Term Adoption

BACKGROUND

The COVID-19 pandemic led to the rapid implementation of remote work, but few studies have examined the impact. We evaluated clinical staff experience with working remotely at a large, urban comprehensive cancer center in Toronto, Canada.

METHODS

An electronic survey was disseminated between June 2021, and August 2021, via e-mail to staff who had completed at least some remote work during the COVID-19 pandemic. Factors associated with a negative experience were examined with binary logistic regression. Barriers were derived from a thematic analysis of open-text fields.

RESULTS

Most respondents (N = 333; response rate, 33.2%) were age 40-69 years (46.2%), female (61.3%), and physicians (24.6%). Although the majority of respondents wished to continue remote work (85.6%), relative to administrative staff (admin), physicians (odds ratio [OR], 16.6; 95% CI, 1.45 to 190.14) and pharmacists (OR, 12.6; 95% CI, 1.0 to 158.9) were more likely to want to return on-site. Physicians were approximately eight times more likely to report dissatisfaction with remote work (OR, 8.4; 95% CI, 1.4 to 51.6) and 24 times more likely to report that remote work negatively affected efficiency (OR, 24.0; 95% CI, 2.7 to 213.0); nurses were approximately seven times more likely to report the need for additional resources (OR, 6.5; 95% CI, 1.71 to 24.48) and/or training (OR, 7.02; 95% CI, 1.78 to 27.62). The most common barriers were the absence of fair processes for allocation of remote work, poor integration of digital applications and connectivity, and poor role clarity.

CONCLUSION

Although overall satisfaction with working remotely was high, work is needed to overcome barriers to implementation of remote and hybrid work models in the health care setting.

Feasibility, acceptance and factors related to the implementation of telemedicine in rural areas: A scoping review protocol

Background

Telemedicine is a quickly developing service that offers more people the access to effective and high-quality healthcare. Societies residing in rural places tend to travel long distances to receive health care, usually have limited access to health care and/or postpone getting health care until a health emergency occurs. However, for telemedicine services to be accessible, a number of prerequisites including the availability of cutting-edge technology and equipment in rural areas must be present.

Objective

This scoping review aims to collect all available data on the viability, acceptability, challenges and facilitators of telemedicine in rural areas.

Methods

PubMed, Scopus and Medical collection of ProQuest are the databases chosen for an electronic search of the literature. Identification of the title and abstract will be followed by an evaluation of the paper's accuracy and eligibility in a two-fold mode; whereas the identification of papers will be openly and completely described using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flowchart.

Conclusion

This scoping review would be among the first to offer a thorough evaluation of issues related to the viability, acceptance and implementation of telemedicine in rural areas. In order to improve the conditions of supply, demand and other circumstances relevant to the implementation of telemedicine, the results would be helpful in providing direction and recommendations for future developments in the usage of telemedicine, particularly in rural areas.

Survey of the patients' perspectives and preferences in adopting telepharmacy versus in-person visits to the pharmacy: a feasibility study during the COVID-19 pandemic

Background

Following the coronavirus disease 2019 (COVID-19) pandemic, the health authorities recommended the implementation of strict social distancing and complete lockdown regulations to reduce disease spread. The pharmacists quickly adopted telemedicine (telepharmacy) as a solution against this crisis, but awareness about this technology is lacking. Therefore, the purpose of this research was to explore the patients' perspectives and preferences regarding telepharmacy instead of traditional in-person visits.

Methods

An electronic questionnaire was designed and sent to 313 patients who were eligible for the study (from March to April 2021). The questionnaire used five-point Likert scales to inquire about motivations for adopting telepharmacy and in-person visits, their perceived advantages and disadvantages, and the declining factors of telepharmacy. Finally, the results were descriptively analyzed using SPSS 22.

Results

Of all 313 respondents, a total of 241 (77%) preferred appointments via telepharmacy while 72 (23%) preferred in-person services. There was a significant difference between the selection percentage of telepharmacy and in-person services (chi-square 91.42; p < 0.0001). Preference bout the telepharmacy system versus in-person visits to the pharmacy was associated with factors such as "reducing the incidence of contagious disease" (4.41; ± 0.78), "spending less time receiving pharmaceutical services” (4.24; ± 0.86)), and “traveling a shorter distance for receiving pharmaceutical services" (4.25; ± 0.86). "Reducing costs" (90.87%), "saving time" (89.21%), and "reducing the incidence of contagious disease" (87.13%) were the most important reasons for choosing telepharmacy services. Also, “face-to-face communication with the pharmacist” (25%), “low internet bandwidth” (25%), and “reduction of patients' anxiety and the increase of their peace of mind” (23.61%) were the most important reasons for choosing in-person visits.

Conclusion

Survey data indicate that most participants are likely to prefer the use of telepharmacy, especially during crises such as the current COVID-19 pandemic. Telepharmacy can be applied as an important means and a crucial service to lessen the load on healthcare organizations and expand drug supply shelters in pharmacies. However, there are still substantial hurdles to overcome in order to successfully implement the telemedicine platform as part of mainstream practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-01834-5.

Outpatients' Opinion And Experience Regarding Telepharmacy During The COVID-19 Pandemic: The Enopex Project

Background

Telepharmacy, as a remote pharmaceutical care procedure, is being used worldwide during the COVID-19 pandemic, with the aim of preserving the health of patients and professionals. Its future development should incorporate the assessment of patient perception, but no research study has investigated it.

Objective

The objective was to poll the opinions and experiences of outpatients with telepharmacy through a purpose-developed questionnaire and to assess it’s quality through an internal validity and reliability analysis.

Methods

Cross-sectional observational study of adult patients who used telepharmacy services during the COVID-19 lockdown period in Spain. The subjects answered a 24-item questionnaire, after giving their informed consent. Place of delivery, informed pharmacotherapeutic follow-up, opinion about telepharmacy, future development, ethics/satisfaction, and coordination constituted the six questionnaire categories. After assessing the adequate sample size with the Kaiser–Meyer–Olkin test, the Bartlett sphericity test analyzed the validity of the questionnaire. The intraclass correlation coefficient and Cronbach’s α coefficient calculations verified the reliability and internal consistency.

Results

A total of 9442 interviews were administered to patients from 81 hospitals, of which 8079 were valid (52.8% female). A 54.1% were aged between 41–65 years; 42.7% had been in treatment for more than 5 years; 42.8% lived between 6–31 miles from the hospital. As many as 96.7% of patients were “satisfied” or “very satisfied” with telepharmacy, 97.5% considering it complementary to their usual follow-up; 55.9% expressed a preference for being followed up face to face when visiting the hospital. 75.6% said they had rather receive their medication at home. The sample size obtained was deemed appropriate [the Kaiser–Meyer–Olkin test (0.789) and Bartlett’s sphericity test (p<0.005)]. The reliability analysis resulted in a Cronbach α = 0.7.

Conclusion

Patients have shown high satisfaction with telepharmacy and the ENOPEX questionnaire is a tool with sufficient validity and reliability to be used in the evaluation of the care that patients receive through telepharmacy.

Expanded roles of community pharmacists in COVID-19: A scoping literature review

Background

Coronavirus disease 2019 (COVID-19) has affected the world health care system adversely, but it has also brought out innovative roles for health care professionals to cater to growing health care needs. Community pharmacists provide community pharmacy services and can play a vital role in fighting the pandemic by taking on novel roles that complement their pre-existing roles.

Objectives

This study aimed to provide a scoping review of current and emerging literature about the novel roles adopted by community pharmacists during the COVID-19 pandemic.

Methods

Online databases such as Google Scholar and PubMed were searched systematically using the keywords “COVID-19,” “pharmacist,” and “community.” Articles were selected based on availability of full text in English language, with time limit from December 1, 2019, to October 31, 2021; case reports, cross-sectional studies, literature reviews, qualitative studies, and systematic reviews were included, whereas commentary reviews and editorials were excluded from the search methodology. An independent review of the articles was conducted for inclusion based on relatability to study subject; those chosen were screened for references to find additional gray literature. Findings were arranged in themes, and the results were organized accordingly.

Results

Novel roles for community pharmacists were found in relation to maintenance of drug-supply chains, delivery of telepharmacy and telehealth services, provision of ambulatory pharmacy services, use of digital software to coordinate medication delivery for patients with chronic conditions, dispelling of misinformation, and roles in research and clinical trials. Roles in a post-COVID world regarding immunization of population and involvement in lifting lockdown strictures alongside other stakeholders were also explored.

Conclusion

Although COVID-19 has challenged the health care system, it has also provided an opportunity for development of novel and innovative roles that can ultimately have profound consequences for the health care system. Community pharmacists, despite facing multiple challenges in the community, should be facilitated to adapt with these new roles, which can be beneficial in achieving mass immunization and better health care in a post-COVID world.

Telepharmacy during COVID-19: A Scoping Review

The objective of this scoping review is to summarize the implementation of telepharmacy during the surge of COVID-19. This review will focus on answering four questions: During the COVID-19 pandemic, (1) what were the various telepharmacy initiatives implemented? (2) what were the challenges faced when implementing telehealth initiatives? (3) what were the strategies used by pharmacies to overcome the challenges, and (4) what were some of the innovative methods used by pharmacies to implement telepharmacy? A literature search was conducted to include publications post-March 2020 about telepharmacy implementation via PubMed Central database and Google searches. All articles were examined for inclusion or exclusion based on pre-determined criteria. A total of 33 articles were reviewed. The most commonly observed telepharmacy initiatives were virtual consultations, home delivery of medicines and patient education. Limited access to technology and lack of digital access and literacy were major barriers in the implementation of telepharmacy. New protocols were developed by healthcare systems and regulations were relaxed by countries to accommodate telepharmacy. Pharmacies that successfully implemented telepharmacy overcame these challenges through patient and pharmacist education. The review also revealed the steps that can be taken by pharmacy organizations, payers and entrepreneurs in leveraging the convenience of telepharmacy.