Virtual medication tours with a pharmacist as part of a cystic fibrosis telehealth visit

Patient and caregiver experience with telepharmacy in cancer care to support beginning systemic therapy: A qualitative study

INTRODUCTION

Although the COVID-19 pandemic spurred telehealth adoption for many specialties and care team roles, the patient and caregiver experience for telepharmacy visits has been relatively understudied. To our knowledge, there is a paucity of studies that have attempted to qualitatively evaluate this. This study aimed to qualitatively assess the patient and caregiver experience of telepharmacy visits in a cancer center.

METHODS

Semistructured interviews were conducted with 21 patients with cancer and seven caregivers that had attended a telepharmacy visit between December 1, 2021, and May 24, 2022. The interviews assessed visit content, overall satisfaction, system experience, visit quality, and future preferences for pharmacy visits as telehealth versus in-person. We used both deductive and inductive coding to identify themes.

RESULTS

Telepharmacy delivery was generally well-received. Reasons for having the telepharmacy visit included reviewing chemotherapy procedures, side effects to expect during treatment, providing education on recently prescribed medications, offering dietary recommendations (e.g., avoiding grapefruit juice), and performing medication reconciliation. Participants were receptive to having pharmacy visits through telehealth due to the perceived lack of a need to have a physical exam and prior relationship with the pharmacist. Participants also highlighted the main reason for the telepharmacy visits was primarily to provide patient education, which participants felt was suitable for telehealth.

CONCLUSIONS

The patient and caregiver experience of telepharmacy is influenced by several factors, such as ease of connectivity, communicating effectively with the pharmacist, and timing of the telepharmacy visit (e.g., immediately after picking up medications from the pharmacy). Participants' recommendations to improve telepharmacy delivery included health systems raising awareness of telepharmacy services and providing a list of questions to patients to guide discussions.

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.

The Impact of Pharmacists on Telehealth During Transitions of Care: A Literature Review

Purpose: To provide a review of pharmacists' impact during transitions of care (TOC) visits utilizing telehealth. Methods: An electronic literature review was conducted on studies that addressed pharmacists' impact on telehealth during TOC. Articles included in the review were randomized or observational studies, cohort studies, case series or case reports, literature reviews, or pilot studies conducted on adults. Articles investigating children were excluded from the review. Results: Of the articles identified, 14 studies met the eligibility criteria and were selected for the literature review. All of the studies were published in English between 2013 and 2021. Most were conducted in the United States of America (n = 12) with 1 conducted in Ireland (n = 1) and 1 in Australia (n = 1). The majority of telehealth monitoring was conducted via phone (n = 8), video conferencing (n = 3), or both (n = 2) in patients' homes by pharmacists alone (n = 8) while the remaining studies involved telemonitoring by a combination of pharmacy fellows, residents, and/or students. These findings showed that pharmacist intervention in patient care showed improved patient outcomes and goal markers for a variety of health conditions as well as lower rates of 30 day, 60 day, and 90 day hospital readmissions. Conclusion: Pharmacist involvement in telehealth monitoring had a positive impact on TOC interventions and overall patient outcomes including decreased hospital readmissions and increased patient medication adherence.

Systematic literature review of adopting eHealth in pharmaceutical care during COVID-19 pandemic: recommendations for strengthening pharmacy services

OBJECTIVES

The study aimed to determine how eHealth was adopted in pharmaceutical care (PC), the outcome reported and the contextual factors.

DESIGN

Systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

DATA SOURCES

Literature was searched in six databases including PubMed, Scopus, Medline, Web of Science, Science Direct and China National Knowledge Infrastructure.

ELIGIBILITY CRITERIA

Studies which reported the usage experiences of eHealth in any aspects of PC by pharmacists during the COVID-19 pandemic, written in English or Chinese, and published in peer-reviewed journals between December 2019 and March 2022 were included. Opinion articles, conference abstracts, correspondence, letters and editorials were excluded.

DATA EXTRACTION AND SYNTHESIS

The literature search was completed on 15 April 2022. Two researchers independently conducted the literature search and extracted the data into an Excel table informed by the logic model with the key components of goals, input, activities, output and contextual factors.

RESULTS

Forty-three studies were included in this review. During the COVID-19 pandemic, hospital pharmacists, community pharmacists and specialist pharmacists in 17 countries continued to educate, consult, monitor and manage the patients and the general public via phone calls, videoconferences, mobile applications, social media, websites and/or enhanced interoperability of electronic medical records. Assuring the continuity of pharmacy care, reduced need for hospital visits, and improved work accuracy and efficiency were the benefits of eHealth mostly reported. Contextual factors affecting the adoption of eHealth were multifaceted, prompting supporting actions at the levels of government, hospital/pharmacy, pharmacists and patients.

CONCLUSION

This study revealed the wide adoption of eHealth in PC during the pandemic and the emerging evidence for its importance. Proper adoption of eHealth will help reshape the mode of pharmacy services to ensure continuity, quality and efficiency of care amid the challenges of the pandemic.

PROSPERO REGISTRATION NUMBER

CRD42022299812.