Application, Benefits, and Limitations of Telepharmacy for Patients with Diabetes in the Outpatient Setting

Validation of a Scorecard of Quality and Activity Indicators for Telepharmacy Pharmaceutical Care Services in Spanish Hospitals

Purpose

Telepharmacy must be monitored within a quality management system in order to guarantee the efficiency, safety and quality of the activities it encompasses. The Spanish Society of Hospital Pharmacy has proposed the first scorecard of quality and activity indicators for Telepharmacy (TIS). The objective of this project is to validate this TIS for its implementation in hospital pharmacy services.

Material and Methods

The project was developed in 4 phases: elaboration of the validation questionnaire/validation criteria; selection of hospitals where the study will be carried out; completion of the validation questionnaire by the selected hospitals; analysis of the results, a proposal of conclusions, and preparation of the final document. The validation criteria were performed using the RAND/UCLA methodology for each of the 5 TIS characteristics: holistic, practical, quantitative, usability, and continuous improvement. Characteristics were considered validated when the median was found to be within the score range 5-9 and at least 2/3 (66.66%) of the respondents scored in the range containing the median.

Results

Forty-four hospitals were included and the responses related to TIS characteristics were: holistic=8.2 and 98.5% of responses >5; practical=7.9 and 98.9% of responses >5; quantitative=7.9 and 98.6% of responses >5; usability=6.9 and 87.37% of responses >5; continuous improvement= 7.9 and 100% of responses >5.

Discussion

TIS has been validated for use in hospital pharmacy services and its tools and supporting documents are very useful and comprehensive. Hospital informatics systems are needed to allow efficient extraction of the data necessary to obtain the TIS indices.

Adoption of electronic patient medication records in community pharmacies in the United Arab Emirates: A cross-sectional survey

BACKGROUND

Access to accurate and relevant patient health information is crucial for community pharmacists to deliver high-quality care. The use of electronic patient medication records (e-PMR) in the United Arab Emirates (UAE) is currently limited to hospital settings, and community pharmacists do not have access to patient records.

OBJECTIVE

To evaluate the perceptions of community pharmacists regarding the potential benefits, barriers, and concerns associated with the implementation of the e-PMR system in community pharmacies in the UAE.

METHOD

A validated questionnaire was administered to a sample of licensed community pharmacists using proportionate random sampling. The survey was structured and consisted of 40 questions in four sections: characteristics of community pharmacists and pharmacies; perceived usefulness of e-PMR; perceived barriers; and concerns about the use of e-PMR.

RESULTS

In total, 552 pharmacists filled out the questionnaire (82.1% response rate). The majority of participants somewhat or strongly agreed that e-PMR would reduce drug abuse (71.6%), dispensing errors (64.4%) and prescribing errors (69.0%), and believed that e-PMR would enhance pharmacists' ability to perform medication reviews (76.0%). Pharmacists in charge (adjusted odds ratio (AOR) = 2.5; 95% confidence interval (CI): 1.6-3.6), facing difficulty tracking the medical history of patients (AOR = 3.2; 95% CI: 2.8-3.9) and working in pharmacies providing telepharmacy services (AOR = 3.4; 95% CI: 2.7-3.8) were more likely to consider e-PMR useful.

IMPLICATIONS

The implementation of the e-PMR system in community pharmacies has potential benefits for patient safety and medication therapy management in the UAE.

The influence of emotional intelligence on knowledge, perception and readiness on Telepharmacy

INTRODUCTION

Emotional Intelligence (EI) involves skills to recognise, comprehend, and manage emotions that influence thinking. Using EI allows for the integration of emotion into reasoning and problem-solving. If applied effectively, EI can foster positive emotions that promote the deployment of telepharmacy, which involves delivering pharmaceutical services remotely via telecommunication. High acceptance of telepharmacy among users, particularly patients or healthcare providers is associated with their high knowledge, positive perception, and readiness, all influenced by EI. This study investigates undergraduate students' levels of EI, knowledge, degree of perception, and readiness for telepharmacy, examines EI's correlation with all other variables, and compares them across various sociodemographic groups.

METHODS

A cross-sectional online study involving 455 undergraduate students at Universiti Teknologi MARA Cawangan Selangor (UCS) was conducted using a 74-item survey distributed via Google Forms. Data were analyzed using SPSS version 29.

RESULTS

Most participants exhibited high EI (53.3 %), average knowledge (53.2 %), positive perception, and high readiness for telepharmacy. EI positively correlated with both perception (p < 0.001) and readiness (p < 0.001). Differences in knowledge were observed by field of study (p < 0.001) and faculty (p < 0.001), with higher levels among students in the pharmacy field and healthcare-related faculty. Readiness also differed by field of study (p < 0.05) and faculties (p < 0.001), with students in the pharmacy field and healthcare-related faculties exhibiting higher readiness.

CONCLUSION

EI is crucial for the successful implementation of telepharmacy services in the future. Enhancing knowledge, perception, and readiness towards telepharmacy among undergraduate students is essential for improving its acceptance and future use.

Usefulness of urine dipstick test in the management of adverse events associated with immune checkpoint inhibitors

PURPOSE

The usefulness of urine dipstick tests (UDTs) in patients with diabetes has been reported. The aim of the present study was to investigate the utility of self-performed UDTs and patient diaries in the management of impaired glucose tolerance, one of the adverse events of immune checkpoint inhibitors (ICIs).

METHODS

Patients receiving ICIs underwent self-checks with UDTs twice a week for up to 6 months. Pharmacists checked the results at every patient visit, and by phone every 3 months. The primary endpoint was to prospectively assess whether symptoms recorded in patient diaries and UDTs could reduce unscheduled hospital admissions due to impaired glucose tolerance. The secondary endpoint was the correlation between the symptoms in the patient diaries and UDT results.

RESULTS

A total of 112 patients were enrolled in the study. Out of the 3197 planned self-UDTs, 3128 (97.8%) were performed. Forty-four patients (39.3%) were admitted to the hospital, two (1.8%) of whom were admitted due to abnormal glucose tolerance, with one having a positive UDT. There were 46 unscheduled outpatient visits (41.1%), of which five (4.5%) were due to abnormal glucose tolerance symptoms and four were due to a positive UDT. The correlation between descriptions of fatigue or dry mouth in the patient diaries and positive glucose UDTs was 52.4% in sensitivity and 62.4% in specificity.

CONCLUSION

Self-monitoring of symptoms and self-performing of UDTs could not reduce the emergency hospitalization rate. However, this approach could be effective in the objective monitoring of patient status, especially regarding glucose intolerance occurrences.

Exploring telepharmacy: A bibliometric analysis of past research and future directions

This bibliometric review analyzes the evolution of telepharmacy research, significantly amplified by the COVID-19 pandemic. By employing bibliometric analysis, the study aims to provide a comprehensive overview of the current state and emerging trends in telepharmacy. This approach helps in identifying key areas of growth, predominant themes, and potential gaps in the literature. Utilizing data from 330 papers (1981-2023) sourced from Scopus and analyzed with Bibliometrix™, this study applies both performance analysis and science mapping methods to examine the telepharmacy literature. The findings reveal a consistent growth in telepharmacy research, with an 8.07 % average annual growth rate. Performance analysis highlights key authors, influential works, and leading journals and countries in the field. Document co-citation analysis identifies four developmental phases of telepharmacy: emergence, take-off, expansion, and future trajectory by uncovering the intellectual structure of the field. Co-words analysis elucidates evolving conceptual structures and significant subfields over time. These findings serve to inform practitioners and researchers about the evolving landscape of telepharmacy, guiding future research and practice in this increasingly important field.

Embracing telepharmacy: Unveiling Malaysians' perceptions and knowledge through online survey

The expansion of information technologies, particularly during the COVID-19 pandemic, has notably increased the use of remote services, including telehealth. Telepharmacy, a subset of telehealth, offers remote pharmaceutical care services, benefiting patients by providing advice and consultations without the need for physical pharmacy visits. This study aimed to assess public perceptions and awareness of telepharmacy in Malaysia. A cross-sectional study was conducted from Nov 2022 to May 2023, involving 387 Malaysian citizens aged 18 and above. Data collection utilised Google Forms distributed via social medias, covering demographics, technological readiness, awareness, perceptions, and willingness related to telepharmacy. The study demonstrated high digital readiness among respondents, owning smartphones and being adept in utilising various digital features. However, there was a lack of awareness regarding the concept of telepharmacy. Despite predominantly positive perceptions of its potential, only 48.1% of respondents showed willingness to utilise telepharmacy services. While respondents exhibited readiness for digital engagement, there was a notable deficit in understanding telepharmacy. Though perceptions were positive, willingness to embrace telepharmacy was moderate. Addressing the knowledge gap through targeted education initiatives might enhance acceptance. Future research should focus on integrating telepharmacy into healthcare systems considering public preferences, thereby evaluating its actual implementation and outcomes among diverse demographics.

Factors Influencing Public Attitudes and Willingness to Utilize Telepharmacy Services in the UAE

Background: Telepharmacy, utilizing telecommunications to dispense pharmaceutical products and deliver patient care, offers numerous benefits for both the public and pharmacists. Previous research on exploring attitudes and willingness to use telepharmacy services has primarily focused on pharmacists rather than the general population. Aim: This study is aimed at assessing the attitudes and willingness of the United Arab Emirates (UAE) population to utilize telepharmacy services and identifying the factors influencing their inclination to use these services. Methods: In this cross-sectional study, a survey was distributed using convenience and snowball sampling to individuals aged 18 or older across the UAE through various social media platforms, including Twitter, Facebook, and WhatsApp. The survey domains included sociodemographics, attitudes, and readiness to utilize a telepharmacy service. A binary logistic regression analysis was conducted to investigate the variables associated with participants' willingness to utilize telepharmacy in the future. Results: In total, 963 individuals participated in the study. Participants showed overall positive attitudes towards telepharmacy, with 70.9% believing that telepharmacy saved time and effort. While only 32% of the participants acknowledged that numerous telepharmacy services were available for use in the UAE, most were interested in using telepharmacy services in the future (79.2%). Participants who had higher attitude scores (AOR = 1.147, 95% confidence interval [CI]: 1.11-1.18) and those who had used these services previously (AOR = 3.270, 95% CI: 1.692-6.320) were more interested in using telepharmacy services in the future. Conclusion: Forthcoming healthcare strategies should focus on expanding the availability of telepharmacy services throughout various regions of the country. This expansion will facilitate the broader utilization of these services and ultimately contribute to improved health outcomes.

Evaluation of remote pharmacist intervention on type 2 diabetes hemoglobin A1c reduction in an accountable care organization

Background

The value of clinical pharmacists for ambulatory internal medicine clinics is well recognized, including their role in hemoglobin A1c (HbA1c) reduction in patients with type 2 diabetes mellitus (T2DM). However, there is a lack of data evaluating the clinical impact of remote, referral-based pharmacy programs.

Methods

This multicenter, cohort, retrospective chart review study analyzed the impact of pharmacist interventions on blood glucose control in patients aged 18 years and older who were diagnosed with T2DM with an HbA1c of 8.5% or greater and referred to the clinical pharmacy team for medication evaluation. Primary care providers may have accepted or rejected pharmacist recommendations. The primary study outcome was the mean change in HbA1c from baseline to follow-up at 2 to 5 months. Secondary outcomes included appropriate use of American Diabetes Association-indicated secondary prevention and any occurrence of glycemia-related events (i.e., T2DM-related emergency room visits or hospitalizations).

Results

At the conclusion of the study, the mean change in HbA1c from baseline to follow-up at 2 to 5 months was -2.7% and -0.6% for the accepted and rejected intervention groups, respectively (t = -2.94, P = 0.0068).

Conclusions

The results of this study suggest that remote pharmacist intervention significantly improves blood glucose control in adults with T2DM.

Exploring Pharmacist Roles in Telepharmacy for Chronic Disease Management in New York State: A Qualitative Inquiry into Improving Implementation, Patient Communication, and Healthcare Technology Support

Background This qualitative study aimed to collect information regarding pharmacists' roles in telepharmacy and chronic disease management (CDM). The literature review was conducted on historical overview, CDM overview, social determinants of health (SDOH), disparities, hospital readmissions, adverse drug events, best practices, and global implications of telepharmacy. Materials and methods Eleven licensed pharmacists from New York working in retail or hospital settings were interviewed using 16 questions. The interview covered topics such as CDM, hospital readmissions, adverse drug events, best practices, SDOH, and health disparities. The recordings of these interviews were transcribed and coded for each open-ended question, resulting in 136 different codes. Results According to the comprehensive review of interview transcripts, there is still an urgent need for communication between healthcare providers and patients, pharmacist training for telepharmacy services and SDOH, and healthcare technology support. CDM can be advanced by pharmacists by understanding patient barriers, SDOHs, health disparities, and pill burdens, as well as incorporating a multidisciplinary approach to patient care. Pharmacists must facilitate open communication, overcome technological barriers, seek support from stakeholders for telepharmacy training, and integrate new mobile applications to improve telepharmacy implementation and operations for providing interventions. Conclusion The research provides insights into the comprehensive impact of telepharmacy on healthcare delivery and its potential to transform CDM. With the expansion of telepharmacy, individuals living with chronic diseases can experience improved medication adherence and overall health outcomes.

Abdelkarim R, Jubran T, Nwar W, Alqahtani A, Alshehri M, Saeed M, Khaled A. Community Pharmacists' Knowledge and Perception towards Telepharmacy Services and Willingness to Practice It in Light of COVID-19

Background

During the COVID-19 pandemic, there was increased adoption of telepharmacy, which has proven benefits. This study was conducted to assess the knowledge and perception of the community pharmacists of Aseer region, Saudi Arabia, towards telepharmacy services and evaluate their willingness to adopt telepharmacy in clinical practice during the COVID-19 pandemic.

Materials and Methods

A cross-sectional study was conducted using an online self-administered structured anonymous questionnaire on the community pharmacists of Aseer region, Saudi Arabia. It covers demographics, computer access and literacy, knowledge and perception, and willingness to practice telepharmacy. Results were expressed as frequencies, percentages, and mean. The comparison between the classes of the demographic variables and the scores was done via Kruskal-Wallis and Mann-Whitney tests.

Result

About half of the pharmacists in our study showed average knowledge about telepharmacy, the practical application of telepharmacy technology, and telepharmacy guidelines with a percentage of 53%, 52%, and 47%, respectively). Majority of the participants showed high perception towards telepharmacy in Saudi Arabia, while 93% of the pharmacists in Saudi Arabia agreed that the implementation of telepharmacy technology is appropriate due to the current COVID-19 pandemic. Only a significant relation was found between gender and computer access, literacy, and perceptions towards telepharmacy with p values of 0.033 and 0.026, respectively.

Conclusion

The majority of the community pharmacists exhibited a positive perception and are willing to practice the concept of telepharmacy despite having a below average knowledge of telepharmacy. A future study involving the entire kingdom of Saudi Arabia could help identify the gaps in the knowledge, perception, and willingness to practice telepharmacy on a broader scale and thus promote telepharmacy adoption in the entire kingdom.

Knowledge, Perception, and Readiness of Indonesian Pharmacists for the Implementation of Telepharmacy-Based Pharmaceutical Services in Indonesia

Background

Telepharmacy, a digital technology-driven approach, has emerged as a potential solution to address the challenges posed by this pandemic. Telepharmacy is a method used in pharmaceutical practice where a pharmacist utilizes telecommunications technology to supervise aspects of pharmacy operations or provide patient care services. This study aimed to assess pharmacists' level of knowledge, perception, and readiness toward telepharmacy in Indonesia.

Methods

A cross-sectional approach was used in this study, and non-probabilistic purposive sampling technique was used to select respondents who were Indonesian pharmacists. The Telepharmacy Knowledge, Perception, and Readiness questionnaire, translated into Indonesian and administered online, was used to measure the pharmacist's knowledge, perception, and readiness level. Descriptive and inferential data analyses were performed using SPSS version 26, with a p-value of ≤0.05 considered statistically significant.

Results

A total of 378 responses were obtained, with 96.83% exhibiting high knowledge and 63.23% showing high readiness for telepharmacy services. Furthermore, 58.20% of respondents had a positive perception of telepharmacy services. The results indicate a significant influence of pharmacist's knowledge and perception on their readiness to implement telepharmacy services in the future practice.

Conclusion

Most study participants had sufficient knowledge, positive perceptions, and readiness to implement telepharmacy services in their future pharmaceutical practice. However, they expressed concerns about the potential for an increased workload and the potential lack of incentives associated with the widespread adoption of telepharmacy practice models. Telepharmacy practice models must be included in the training programs that train future's pharmacists in order to ensure that they have the abilities required to offer telepharmacy services.