Facilitators, Barriers, and Potential Impacts of Implementation of e-Pharmacy in India and its Potential Impact on Cost, Quality, and Access to Medicines: Scoping Review.

BACKGROUND: e-Pharmacy can potentially solve problems related to the quality of services and products, cost, and access to medicines in low- and middle-income countries. This review aims to understand the facilitators and barriers to the implementation of e-pharmacy in India. OBJECTIVE: This scoping review aimed (1) to understand the facilitators and barriers to the use of e-pharmacy in India and (2) to estimate the potential for e-pharmacy in India for improving access to medication, improving the quality of services and medicines, and decreasing costs of medications. METHODS: All published and gray literature from July 1, 2011, to June 30, 2021, relating to e-pharmacy, was searched from MEDLINE, Scopus, ProQuest, and Google using a systematic search strategy. RESULTS: In total, 1464 titles and abstracts were screened, of which 47 full-texts were included in the review. e-Pharmacy can potentially improve access to medications for remote areas, and old and debilitated individuals. e-Pharmacies can enable lean supply chain management, lower cost, and allow easy tracking of dispensed medicines. There is potential for integration of e-pharmacy services into the national program of Bhartiya Jan Aushadhi Pariyojana. However, the country is not adequately regulated to prevent the growth of illicit e-pharmacies. Lack of global accreditation and internet coverage, digital literacy, and transnational access are other challenges. CONCLUSIONS: E-pharmacy has the potential to improve universal health coverage in India by improving access to medicines and lowering the overall cost of health care. However, future growth will need specific regulations and accreditation mechanisms. TRIAL REGISTRATION: Open Science Forum; https://doi.org/10.17605/OSF.IO/6R9YQ.

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.

Telepharmacy for outpatients with cancer: An implementation evaluation of videoconsults compared to telephone consults using the CFIR 2.0.

Background: Medication history telepharmacy consults are conducted prior to patients commencing their systemic anti-cancer therapy. At the study institution, this has historically been carried out as an unscheduled telephone consult. However, due to challenges with telephone consults, a scheduled videoconsult model was established. Funding, time efficiency, and completion rate for videoconsults compared to telephone consults have been examined previously. Objective: The aim of this study was to determine staff perceptions of the factors that influence implementation, including enablers and barriers, for videoconsults compared to telephone consults, to inform model sustainability. Methods: Semi-structured interviews were conducted with staff (n = 14) involved with the videoconsult service, or who provided care for patients who had a videoconsult. Interviews were coded for positive or negative influence and strength using the Consolidated Framework for Implementation Research (CFIR) 2.0, to understand which constructs influence implementation. Results: Thirty-nine of the 79 constructs, from across four domains were identified as influences for the telephone and videoconsult models. Six constructs were strongly differentiating for videoconsults over telephone consults. Of the 25 positively influencing constructs for the videoconsult model, strongest ratings (+2) were given for innovation advantages, critical incidents, support persons assisting in the consult, financing related to funding reimbursement, and telehealth coordinator capability and motivation. Barriers unique to the videoconsult model included the many steps that were involved, compatibility with workflows, and pharmacist resource. Similarities and differences unique to each model were identified. Conclusion: Findings demonstrated a number of strongly differentiating constructs highlighting superiority of the videoconsult model. However, implementation of both models had multiple enablers and barriers that may influence adoption. The potential of a hybrid service, using both telephone consults and videoconsults, may help optimise delivery of services.

Knowledge and Perception of Pharmacy Students toward Telepharmacy Education in Saudi Arabia.

Telepharmacy education should be incorporated into the curricula due to its beneficial effects on students, providing pharmacy services during their practice. Therefore, this study aims to explore the knowledge and perceptions of pharmacy students regarding the integration of telepharmacy services into their education curriculum in Saudi Arabia. A cross-sectional study was conducted using an online survey from 1 June to 30 September 2023, among pharmacy students from five universities in Saudi Arabia. The questionnaire was divided into three sections, and descriptive statistics and a generalized linear model were used for analysis. A total of 523 pharmacy students participated. Approximately half of the students were aware of telepharmacy, and only one-quarter had studied it as part of their curriculum. Students believed that telepharmacy education should cover communication, reimbursement, and training for virtual patient interactions. There was a significant positive correlation (p < 0.0001) between the knowledge and perception scores. In addition, students who had heard about telepharmacy before and those with a "somewhat" confidence level showed a significantly positive correlation with knowledge scores (p = 0.01). In conclusion, perception scores, students who had heard of telepharmacy, and those with a "somewhat" confidence level were all positively correlated with pharmacy students' understanding of telepharmacy. This study underscores the importance of integrating telepharmacy education and practical training into pharmacy curricula to prepare future pharmacists for the evolving healthcare landscape.

"I'm not very skilled in using gadgets:" A qualitative exploration of the facilitators and barriers to using telepharmacy services among Filipino senior citizens.

Background: Telepharmacy provides remote care by pharmacists to distant patients via telecommunications. It is a new service used in the Philippines during the COVID-19 pandemic. However, its utilization among vulnerable populations, notably senior citizens, remains relatively unexplored. Objective: This study explored the facilitators and barriers to telepharmacy use among senior citizens in Pasig City, Philippines. Pasig City, a highly urbanized area in Metro Manila, is known for its quality and accessible healthcare services and has a high population of senior citizens. Methods: Six focus groups were conducted: three with telepharmacy users and three with non-users, each with 3-5 participants. Focus groups were concluded upon reaching data saturation, where no new insights emerged. Verbatim transcripts were analyzed using deductive and inductive content analysis, guided by the Health Belief Model. Coding and data management were facilitated by MAXQDA software. Results: Filipino senior citizens recognize the convenience and reliability of telepharmacy services for healthcare advice. Their use is influenced by social factors (friends, family, social media) and personal relevance, especially for those with chronic conditions. Positive experiences increase their likelihood of continued use and recommendations to peers. However, barriers such as poor service knowledge, low self-efficacy, and limited access (lack of smartphones, unreliable internet) hinder broader adoption. Conclusions: Telepharmacy enhances the health and well-being of Filipino senior citizens by offering convenient and effective pharmaceutical care. However, barriers exist that need to be addressed through a multifaceted approach, including education and training for seniors, improved internet infrastructure, and the design of user-friendly platforms.

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.

Telepharmacy in Indonesia: Navigating Knowledge, Perception, and Readiness Among 6,000 Pharmacists and Related Sociodemographic Determinants.

Introduction: Telepharmacy can improve the delivery of pharmaceutical care services to patients. However, there are limited data regarding the knowledge, perceptions, and readiness (KPR) for telepharmacy in Indonesia. In this cross-sectional survey study, we assessed KPR and associated factors among Indonesian pharmacists, aiming to implement telepharmacy services in the future. Methods: Eligible participants were recruited from all provinces of Indonesia through a 24-item instrument. KPR scores were classified as low, moderate, and high. Sociodemographic characteristics and KPR of participants were summarized using descriptive statistics. Bivariate/multivariate ordinal logistic regression analyses were conducted to identify independent determinants of KPR. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was calculated for each determinant. Results: A total of 6,059 pharmacists provided responses. Overall, 58.28% had a high knowledge score, and 63.51% expressed moderate perceptions toward telepharmacy services. Moreover, 70.21% showed a moderate level of readiness. Gender (male; AOR: 1.21 [95% CI: 1.06-1.39]), stable internet access (AOR: 0.75 [95% CI: 0.64-0.86]), and central region (AOR: 1.13 [95% CI: 0.99-1.29]) were significantly associated with perception toward telepharmacy. Readiness was significantly associated with age (17-25 years; AOR: 0.73 [95% CI: (0.60-0.89]), gender (male; AOR: 0.83 [95% CI: 0.72-0.95]), stable internet access (AOR: 0.75 [95% CI: 0.64-0.89]), education level (master/doctoral; AOR: 1.33 [95% CI: 1.06-1.67]), and central region (AOR: 1.29 [95% CI: 1.12-1.49]). Interestingly, knowledge levels were not significantly correlated with specific factors. Conclusions: Participants demonstrated high knowledge, without significant influencing factors. However, they showed moderate perceptions and readiness levels, influenced by sociodemographic factors, including gender, age, education level, internet access, and regional disparities. Therefore, targeted interventions (e.g., telepharmacy training and regional outreach) are imperative to enhancing perceptions and readiness, fostering the effective integration of telepharmacy services, and advancing pharmaceutical care in Indonesia.

Implementation of Telepharmacy to Provide Medication Consultation Service for Patients: A Case Study From Thu Duc City Hospital, Ho Chi Minh City.

Telepharmacy is receiving significant attention as an innovative approach. The objective of this study is to assess the needs and evaluate the impact of telepharmacy applications in drug consultations at Thu Duc City Hospital. We used a cross-sectional research design and conducted a survey with the participation of leaders of the Faculty of Pharmacy, clinical pharmacists, dispensing pharmacists, and patients or their caregivers who receive medication at the Pharmacy of Thu Duc Hospital. We deployed a telepharmacy application for consulting on drug use and surveyed the satisfaction of patients/family members with the telepharmacy model. 60.3% of survey subjects expressed a desire to receive drug use consultations through telepharmacy if the hospital were to offer this service. One hundred percent of the pharmacists at the pharmacy and the hospital's leadership believe that telepharmacy can address patient consultation needs and improve the current physical facilities in the dispensing area. Over 90% of telepharmacy users reported being satisfied or very satisfied with the service. Telepharmacy has garnered the attention of patients, their caregivers, and the medical staff at the Outpatient Pharmacy of Thu Duc Hospital. The majority of users are satisfied with the drug use consultation service provided by telepharmacy. By expanding the good results of Thu Duc Hospital to other hospitals, more patients across Vietnam can benefit from this innovative approach.

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.

Comparing Medication History Capture Rates In-Person Versus Hybrid: A Multisite Pilot Study.

Purpose: Medication history is the method many organizations use to adhere to The Joint Commission's (TJC) National Patient Safety Goal (NPSG) to communicate accurate patient medication information. Literature is sparse comparing the number of medication histories completed in-person versus virtually. Methods: This is a single system, multi-site, retrospective observational study. Patients included were admitted through the Emergency Department during October 2022. The primary aim of this study compared the percent capture rates of medication history between 2 hybrid sites to an in-person site within a health-system. Our secondary objective compared the differences in the 'medication history acuity score' (MHAS), defined as the total number of edits, additions, and deletions made during a medication history. Results: The medication history capture rate at the in-person site was 74% and at the hybrid sites were 91% and 80%. There were no differences in total medications on each medication history between in-person and hybrid (11 [5-16] vs 11 [6-16]; P = .252). There were no differences in changes made on medication histories between in-person and hybrid (4 [1-7] vs 3 [1-7]; P = .595). Conclusions: Our study demonstrates that medication history capture rates and MHAS are comparable in both in-person and hybrid environments. This similarity suggests the feasibility of implementing hybrid models for medication history services in diverse healthcare settings, potentially enhancing the capacity of health systems to meet TJC NPSG. These findings indicate that hybrid models could be an effective strategy for healthcare systems to optimize their medication history services, especially in settings with varied patient volumes and site specialties.

Findings From a National Survey of Older US Adults on Patient Willingness to Use Telehealth Services: Cross-Sectional Survey.

BACKGROUND: Telehealth (telemedicine and telepharmacy) services increase access to patient services and ensure continuity of care. However, few studies have assessed factors that influence patients' willingness to use telehealth services, and we sought to investigate this. OBJECTIVE: This study aims to examine respondents' (aged between 45 and 75 years) willingness to use telehealth services (telepharmacy and telemedicine) and the correlates of the willingness to use telehealth services. METHODS: We administered a cross-sectional national survey of 1045 noninstitutionalized US adults aged between 45 and 75 years in March and April 2021. Multiple logistic regression analyses were used to identify demographic and health service use correlates of self-reported willingness to use telehealth services. RESULTS: Overall willingness to use telemedicine was high (674/1045, 64.5%). Adults aged 55 years and older were less willing to use telemedicine (aged between 55 and 64 years: odds ratio [OR] 0.61, 95% CI 0.42-0.86; aged 65 years or older: OR 0.33, 95% CI 0.22-0.49) than those younger than 55 years. Those with a regular provider (OR 1.01, 95% CI 1-1.02) and long travel times (OR 1.75, 95% CI 1.03-2.98) were more willing to use telemedicine compared to those without a regular provider and had shorter travel times, respectively. Willingness to use telemedicine services increased from 64.5% (674/1045) to 83% (867/1045) if the service was low-cost or insurance-covered, was with their existing health care provider, or was easy-to-use. Overall willingness to use telepharmacy was 76.7% (801/1045). Adults aged older than 55 years were less willing to use telepharmacy (aged between 55 and 64 years: OR 0.57, 95% CI 0.38-0.86; aged 65 years or older: OR 0.24, 95% CI 0.15-0.37) than those younger than 55 years. Those who rated pharmacy service quality higher were more willing to use telepharmacy (OR 1.06, 95% CI 1.03-1.09) than those who did not. CONCLUSIONS: Respondents were generally willing to use telehealth (telemedicine and telepharmacy) services, but the likelihood of their being willing to use telehealth decreased as they were older. For those initially unwilling (aged 55 years or older) to use telemedicine services, inexpensive or insurance-covered services were acceptable.

Clinical Telepharmacy: Addressing Care Gaps in Diabetes Management for an Underserved Urban Population Using a Collaborative Care Model.

Introduction: Optimal chronic care management is limited by low health care access and health literacy among underserved populations. We introduced clinical pharmacy services to enhance our patient-centered home model, which serves mostly Medicare/Medicaid-insured patients. Primary care providers (PCP) refer patients with uncontrolled diabetes to the pharmacist for chronic disease management between PCP appointments to bring A1c to goal under a collaborative agreement. This workflow existed before the COVID-19 pandemic and was primarily in-person visits. Our model transitioned to telehealth, where pharmacy services continued via audio/video visits to avoid disruption in care. Methods: A collaborative scope of practice within care guidelines was developed with PCPs. Established patients with uncontrolled diabetes were referred to the clinical pharmacist. The workflow remained consistent through January 1, 2019 to January 31, 2020 (pre-COVID), and April 1, 2020 to October 31, 2021 (post-COVID). February and March 2020 were excluded due to changing operational processes at the pandemic onset. The pharmacist independently saw patients for medication-related interventions and ordered associated labs within the scope of practice. The program was retrospectively evaluated via process metrics (visit volume and intervention types) and clinical outcome (A1c reduction). Results: A total of 105 patients were referred for diabetes management during the study period. These were in-person pre-COVID (95%) and shifted to entirely audio/video (100%) post-COVID. Impact of pharmacy services was sustained through the change in care model: an A1c reduction of more than 0.5% was observed in 65% (n = 20) and 69% (n = 49) of patients managed by the pharmacist, pre- and post-COVID, respectively. Pharmacy visit volumes were 86 versus 308, respectively. Conclusion: Pharmacy referral and visit volumes increased over the pandemic, made possible via telehealth. The goal attainment rate observed pre-COVID was amplified even with the growth in services over time. Clinical pharmacy services delivered through audio/video telehealth visits may be equally effective compared to face-to-face services.

Building a pediatric neurocritical care program: The role of the clinical pharmacist practitioner on clinical practice and education. A curriculum for neuropharmacology training.

Clinical pharmacists are a part of the integrated health care team and provide valuable input on medication management for patients with acute and chronic disease states. Using epilepsy as a model, pharmacist involvement in patient care has been associated with significant reductions in monthly seizure frequency. Given differences in etiology, pediatric patients with epilepsy are likely to have higher number of treatments, with additional pharmacodynamic and pharmacokinetic differences, adding to the importance of utilizing a pediatric clinical pharmacist practitioner with neuropharmacology expertise. There is an increasing exposure to critically ill patients with epilepsy and other neurological disorders in the pediatric intensive care unit (PICU). These patients are more medically complex, increasing the risk for medication errors and increased health care costs. Emphasis on neurocritical care education is a vital component to improving patient outcomes. Inclusion of a clinical pharmacist practitioner in these settings yields a positive impact on major health outcomes. In 2018, the Neurocritical Care Society developed consensus recommendations on the standards for the development of adult neurocritical care units. A pharmacist-delivered pediatric critical care neuropharmacology rotation represents a novel approach to expanding physician education to improve patient outcomes. While there are sparse publications highlighting the importance of adult critical care and NCC pharmacists, no such literature exists describing the benefits of pediatric neurocritical care (PNCC) pharmacists. To the best of our knowledge, this is the first manuscript describing the role of clinical pharmacist practitioners in the development of PNCC program and the benefits they provide to patient care and education.

Evolution of Telehealth-Its Impact on Palliative Care and Medication Management.

Palliative care plays a crucial role in enhancing the quality of life for individuals facing serious illnesses, aiming to alleviate suffering and provide holistic support. With the advent of telehealth, there is a growing interest in leveraging technology to extend the reach and effectiveness of palliative care services. This article provides a comprehensive review of the evolution of telehealth, the current state of telemedicine in palliative care, and the role of telepharmacy and medication management. Herein we highlight the potential benefits, challenges, and future directions of palliative telemedicine. As the field continues to advance, the article proposes key considerations for future research, policy development, and clinical implementation, aiming to maximize the advantages of telehealth in assisting individuals and their families throughout the palliative care journey. The comprehensive analysis presented herein contributes to a deeper understanding of the role of telehealth in palliative care and serves as a guide for shaping its future trajectory.

A systematic review of synchronous telepharmacy service models for adult outpatients with cancer.

BACKGROUND: Telephone and videoconsults are known synchronous telepharmacy modalities being used to respond to the demand for outpatient pharmacy services. However, little is known about the evidence for cancer telepharmacy service models. OBJECTIVES: To review existing evidence regarding synchronous telepharmacy service models for adult outpatients with cancer, with a secondary focus on outcomes, enablers, and barriers. METHODS: A PROSPERO registered systematic review was conducted using PubMed, CINAHL, and EMBASE in March 2023. Key search terms included pharmacy, telepharmacy, and outpatient. During article selection in Covidence, an extra inclusion criterion of synchronous cancer-focused services was applied; data extraction and narrative analysis were then performed. RESULTS: From 2129 non-duplicate articles, 8 were eligible for inclusion, describing 7 unique patient populations. The service models included pre-treatment medication history taking, adherence monitoring, toxicity assessment, and discharge follow-up. Studies found synchronous telepharmacy services can improve timeliness of care, optimise workload management, and provide individualised and convenient efficacy monitoring and counselling. One study of 177 patients on immune checkpoint inhibitors found 38% of the 726 telephone consults involved at least one intervention. When videoconsults were compared directly with telephone consults for pre-treatment medication history, it was found scheduled videoconsults had a significantly higher success rate than unscheduled telephone consults, and that videoconsults also represented increased funding and equivalent time efficiency. When telephone follow-up was compared to no follow-up, improved treatment adherence was seen, and progression-free survival was significantly higher for the telephone group (6.1 months vs 3.7 months, p = 0.001). Reported enablers included physician buy-in, staff resources, and correct utilisation of technology, while identified barriers included time investment required and technical issues. CONCLUSION: Both telephone and videoconsult modalities are being used to deliver synchronous telepharmacy services across a range of outpatient services. Although more evidence is needed, data to date supports positive service benefits and enhanced care.

Economic evaluations of telepharmacy services in non-cancer settings: A systematic review.

BACKGROUND: Telepharmacy is the provision of pharmacy services from a distance to a patient using telecommunications and other technologies. There has been limited research investigating the cost-effectiveness of telepharmacy services. OBJECTIVE: To provide a comprehensive review and narrative synthesis of the available economic evidence on telepharmacy services in non-cancer settings. METHOD: A systematic literature search of four databases including PubMed, Embase, CINAHL, and EconLit was undertaken to identify economic evaluations comparing telepharmacy services to standard pharmacy care. Abstracts and full texts were screened by two independent reviewers for inclusion against the eligibility criteria. Key economic findings were extracted from included articles to determine the cost-effectiveness of the reported telepharmacy services. RESULTS: The review included six studies; two were cost-minimisation analyses, three were cost effectiveness analyses (CEA) and one study conducted both a CEA and cost-utility analysis. Telepharmacy services predominantly relied upon telephone modes of communication, with three that used remote patient monitoring. These services managed a variety of clinical situations which included newly initiated antibiotics, antiretroviral therapy management, and medications for chronic conditions, as well as hypertension management. Articles were of relatively high reporting quality, scoring an average of 83% on the Consolidated Health Economics Reporting Standards checklist. Four of the six studies reported that telepharmacy was less costly than usual care, with two that reported telepharmacy as cost-effective to the healthcare system according to a specified cost-effectiveness threshold. CONCLUSIONS: Overall, this review demonstrates that there is emerging evidence that telepharmacy services can be cost-effective compared with standard care in non-cancer settings. Further research is needed to complement these findings, particularly reflecting the increased uptake of telehealth and telepharmacy services since the onset of the Coronavirus disease pandemic.

Telepharmacy Implementation to Support Pharmaceutical Care Services during the COVID-19 Pandemic: A Scoping Review.

Background: Telepharmacy was effectively applied for remote pharmaceutical care during the COVID-19 pandemic. Objectives: To determine the implementation of telepharmacy services to support pharmacists in providing pharmaceutical care during the pandemic. Data Sources: Seven electronic databases were searched from inception to June 2021: PubMed, Ovid MEDLINE, Excerpta Medica database (Embase), Web of Science, Proquest, Scopus, and the Cochrane Database of Systematic Reviews. Study Selection and Data Extraction: The review followed PRISMA guidelines and was registered with the PROSPERO registry of systematic reviews. Reports of original research investigating the implementation of telepharmacy during the COVID-19 pandemic were retrieved. Researchers screened the title and abstract of each article, and then evaluated the full text of eligible articles to identify studies that met the inclusion criteria. Pharmacists' responsibilities and actions were classified in relation to the International Pharmaceutical Federation guideline for managing the COVID-19 pandemic. Extracted data included study characteristics, pharmacists' interventions delivered through a telepharmacy system, and the benefits of telepharmacy implementation. Data Synthesis: The database search yielded 1400 articles. After removal of duplicates and articles not meeting the specific inclusion criteria (n = 1381), a total of 19 relevant original research articles were reviewed. According to these studies, telepharmacy was used to perform remote medication review and optimization, assess medication adherence, dispense and deliver medications, educate and counsel patients, promote disease prevention, collaborate with health care providers, and monitor treatment outcomes. Conclusions: This study highlighted the use of telepharmacy services to support pharmacists' activities during the COVID-19 pandemic. Randomized clinical trials are needed to investigate the long-term efficacy and cost-effectiveness of telepharmacy services.

Contexte: La télépharmacie a été efficacement utilisée pour les soins pharmaceutiques à distance pendant la pandémie de COVID-19. Objectifs: Déterminer comment des services de télépharmacie ont été mis en place pour soutenir les pharmaciens dans la prestation de leurs soins. Sources des données: Sept bases de données électroniques ont été utilisées pour effectuer les recherches, pour la période allant du début jusqu'à juin 2021: PubMed, Ovid MEDLINE, Excerpta Medica (Embase), Web of Science, Proquest, Scopus et la Cochrane Database of Systematic Reviews. Sélection des études et extraction des données: L'examen suivait les lignes directrices PRISMA et a été enregistré dans le registre PROSPERO des revues systématiques. Des articles rapportant des recherches originales sur la mise en œuvre de la télépharmacie pendant la pandémie de COVID-19 ont été extraits. Les chercheurs ont examiné le titre et le résumé de chaque article avant d'évaluer le texte intégral des articles admissibles pour identifier les études répondant aux critères d'inclusion. Les responsabilités et les actes des pharmaciens ont été classés selon les lignes directrices de la Fédération internationale pharmaceutique relativement à la gestion de la pandémie de COVID-19. Les données extraites comprenaient les caractéristiques de l'étude, les interventions des pharmaciens effectuées au moyen du système de télépharmacie ainsi que les avantages de la mise en œuvre de la télépharmacie. Synthèse des données: La recherche dans la base de données a rendu 1400 articles. Après suppression des doublons et des articles ne répondant pas strictement aux critères d'inclusion (n = 1381), 19 articles de recherche originaux pertinents ont été examinés. Selon ces études, la télépharmacie était utilisée pour effectuer l'examen à distance de médicaments et leur optimisation, évaluer l'observance de la médication, dispenser et administrer des médicaments, informer et conseiller les patients, promouvoir la prévention des maladies, collaborer avec les prestataires de soins de santé et surveiller les résultats du traitement. Conclusions: Cette étude a mis en évidence l'utilisation des services de télépharmacie pour soutenir les activités des pharmaciens pendant la pandémie de COVID-19. Des essais cliniques randomisés sont nécessaires pour étudier l'efficacité à long terme et la rentabilité des services de télépharmacie.

Virtual Care? Telepharmacy in Critical Care Settings for Patient-Centered Care and Multidisciplinary Collaboration: A Scoping Review of Activities, Benefits, Economic Impact, Challenges, and Knowledge Gaps.

Background: Very few studies have investigated telepharmacy (TP) in critical care. This scoping review undertook this task. Methods: We searched the following five electronic databases (PubMed, Embase, WoS, Scopus, CINAHL). Data were extracted from the articles and mapped out. Arksey and O'Malley's 6-step framework was used, and data synthesis identified activities, benefits, economic impact, challenges, and knowledge gaps of TP in critical care. Results: Out of 77 reports retrieved, 14 were included in the review as per inclusion criteria. Eight studies (57%) were published since 2020, and 9 (64%) were from the United States. Tele-ICU was in place before TP implementation in six studies (43%). TP used a range of synchronous/asynchronous communications. Studies reported wide assortment of reactive/scheduled TP activities. Patient outcomes were evaluated in one study of sedation-related TP interventions but they were not different despite improved compliance with sedation protocol. Most common clinical interventions/drugs included glycemic, electrolyte, and antimicrobial therapy management and antithrombotic agents among others. Acceptance of TP interventions was 75% or more in four studies and 51-55% in two studies. Benefits of TP included resolved drug-related problems, increased compliance with guidelines, maintained interactions with other health care providers, and patient safety among others. Three studies (21%) reported cost avoidance with TP interventions. Challenges included communication, intervention documentation, tracking implementation of recommendations, and monetary/financial and legislative/regulatory issues. Knowledge gaps comprised lack of frameworks for implementation/evaluation of TP in critical care, methodological aspects, lack of patient-specific outcomes, as well as institution/health-system aspects, and documentation systems, cost, legislative, and sustainability issues. Conclusions: TP in critical care is underpublished, and comprehensive frameworks for its implementation and evaluation remain lacking. Assessments are needed to evaluate the effect of TP in critical care on patient-specific outcomes, its economic and legal dimensions, methods to sustain it, as well as the role of documentation systems, collaboration models, and institutional characteristics.