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

Enhancing medication literacy through a telepharmacy call center in Israel: consultation overview and patient satisfaction

BACKGROUND

Telepharmacy, the use of telecommunications technology to facilitate pharmacy services, has emerged as an integral component of telehealth, particularly during the COVID-19 pandemic. In Israel, the shortage of pharmacists nationwide has led to longer wait times and reduced consultation opportunities at community pharmacies. In response, the Pharmaceutical Society of Israel (PSI) established a telepharmacy call center to provide free pharmaceutical consultations to the public. This study aimed to describe the framework of this center, the types of pharmaceutical consultations and patient satisfaction with the service.

METHODS

This cross-sectional observational study analyzed unidentified data from 1,542 ambulatory patient inquiries to the PSI telepharmacy call center between October 2022 and June 2023. The consultations were categorized into clinical, logistical, and patient rights-related inquiries. A satisfaction survey was conducted among a representative sample of callers.

RESULTS

The majority of inquiries (93.3%) were received via telephone, with the 65-85 age group accounting for 38.4% of callers. A small proportion of inquiries were submitted via email, either exclusively or in combination with a telephone communication. Clinical inquiries comprised 89% of the total, with the most common topics being drug interactions (26.7%), general drug usage guidance (17.8%), and inquiries about drug side effects (16.4%). The patient satisfaction survey revealed that 87% of respondents strongly agreed that the pharmacists demonstrated empathy and attentiveness, and 93.5% were satisfied with the responses provided. The overall service rating was 8.9 out of 10, and 94.1% of respondents were willing to recommend the call center to others.

CONCLUSION

This study highlights the value and feasibility of operating a national telepharmacy call center in Israel, addressing the diverse pharmaceutical needs of the public, particularly the elderly population. The high satisfaction levels among callers underscore the potential for such initiatives to enhance access to comprehensive pharmaceutical consultation and improve medication management.

Cost analysis associated with intramuscular versus oral administration of antiretroviral therapy in the management of human immunodeficiency virus infection

OBJETIVE

To identify and analyze the resources and costs associated with the administration of intramuscular antiretroviral therapy (ART) cabotegravir+rilpivirine (CAB+RPV) compared to oral ART in the management of Human Immunodeficiency Virus Type 1 (HIV-1) infection in Spain.

METHODS

An economic model was developed to identify resources and analyze costs from the perspective of the National Health System (NHS) and societal, associated with the administration of intramuscular ART (CAB+RPV) compared to oral ART over a two-year time horizon. Costs included treatment change monitoring, pharmaceutical dispensation, administration, management of adverse events to injection-site reactions (AEs-ISR), travel to the hospital, telepharmacy service, and lost work productivity. Unit costs (€, 2023) were obtained from the literature. Sensitivity analyses were conducted to evaluate the robustness of the model.

RESULTS

Intramuscular ART compared to oral ART was associated with an increase in costs of €673.16/patient over two years from the perspective of the NHS, and €719.59/patient from the social perspective. Intramuscular ART would generate increased costs for dispensation (+€97.75), administration (+€394.55), monitoring (+€288.74), management of AEs-ISR (+€6.46), travel (+€8.36), and lost work productivity (+€38.07), compared to oral ART administration.

CONCLUSION

Treating HIV-1 with intramuscular CAB+RPV leads to increased resource consumption and costs, compared to oral ART.

Knowledge, perceptions, and readiness of telepharmacy (KPR-TP) questionnaire among pharmacists: Development and psychometric evaluation

INTRODUCTION

The pandemic increased pressure on healthcare services and forced limited care in all health facilities to ensure the care of all patients. Telepharmacy appears as an alternative to the remote pharmacy practice approach through information and communication technologies, but there are no comprehensive tools to measure pharmacists' knowledge, perception, and readiness to implement telepharmacy. This study developed and validated a questionnaire version of the Knowledge, Perceptions, and Readiness of Telepharmacy (KPR-TP) for pharmacists.

METHODS

The KPR-TP assessed three domains: knowledge, perception, and readiness. Its factor structure, reliability, and validity were assessed using 7730 pharmacists from 34 Indonesian provinces. The validity of the model's three-factor structure was assessed using confirmatory factor analysis. Cronbach's alpha and composite reliability were used to validate the consistency of our factors, whereas convergent and discriminant validity established significant relationships between them.

RESULTS

The goodness-of-fit index indicated that the model was economical and reasonable. Furthermore, the correlation between the three domains revealed a significant positive relationship. KRP-TP is a viable instrument for assessing pharmacists' perceptions of telepharmacy in Indonesia.

CONCLUSION

Overall, we discovered that our questionnaire contains critical constructs for assessing a pharmacist's knowledge, perception, and level of readiness to implement telepharmacy. This study will help pharmacists identify appropriate strategies for skill improvement.

Telepharmacy versus Face-to-Face Approach in Providing Inhaler Technique Training Service: A Non-Inferiority Assessment Among German Pharmacy Students

Background

The use of telepharmacy in delivering pharmaceutical care services has grown in the past few years; however, there are perceptions of its inappropriateness for providing medical device training among pharmacy students and practicing pharmacists.

Objective

The primary objective of this study was to determine if the telepharmacy approach for providing inhaler technique training service was non-inferior to the face-to-face approach regarding pharmacy students' performance in simulated patient encounters. Secondary objectives were to determine students' self-assessment of their ability to demonstrate and practice inhaler technique between the two modes of communication and their perceptions of telepharmacy.

Methods

A randomized crossover non-inferiority trial was conducted among undergraduate pharmacy students. Outcomes were measured by comparing Objective Structured Clinical Examination (OSCE) scores of participants' performance between two modes of communication while providing inhaler technique training service. Moreover, the participants also completed self-assessment and perception questionnaires.

Results

The telepharmacy approach was non-inferior to the face-to-face approach for demonstrating and practicing the correct inhaler technique based on OSCE scores and a predefined non-inferiority margin of -10%. The results also revealed no significant differences in student self-confidence between the two modes of communication. Moreover, participants had a largely positive perception of telepharmacy and its use in providing inhaler technique training service.

Conclusion

Considering our findings, telepharmacy is a viable alternative to traditional face-to-face consultations for providing inhaler technique training service. However, to address perceived difficulties and differences between virtual and face-to-face consultations, the pharmacy curriculum should include more telepharmacy-related didactic content with experiential learning and simulations.

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.

Delayed and unmet prescription drug access linked to elevated anxiety symptoms during COVID-19: Retrospective findings from the NLSY79 child and young adult cohort

Background

The COVID-19 pandemic produced substantial challenges to pharmacy systems worldwide and provoked concerns about a wider influence on mental health. While various studies have investigated the relationship between disruptions in access to healthcare and mental health, the effects of delayed and unmet access to prescription drugs on anxiety-related outcomes have been underexamined.

Objective

This study analyzed the impact of delayed and unmet access to prescription drugs on anxiety-related outcomes, including anxiety, inability to stop or control worrying, worrying too much, trouble relaxing, trouble sitting still, being annoyed or irritable, and fear of future events, before and during the COVID-19 pandemic.

Methods

A retrospective observational study was performed using the National Longitudinal Survey of Youth 79 Child and Young Adult dataset, encompassing 2193 individuals. One-way multivariate analysis of covariance (MANCOVA) analyses were conducted to examine the relationship between access to prescription drugs and anxiety-related symptoms.

Results

The findings show that, before the pandemic, instances of delayed/unable to access prescription drugs were either not linked to anxiety symptoms or, in some cases, were linked to anxiety symptoms but no different than during the pandemic. Delayed access to prescription drugs amid the pandemic was significantly linked with increases in anxiety symptoms not found pre-pandemic, including worrying too much (F = 18.433, p < .001, η2p = 0.017), trouble relaxing (F = 11.423, p < .001, η2p = 0.010), and being easily annoyed or irritable (F = 3.881, p = .021, η2p = 0.004). Similarly, unmet access to prescription drugs amid the pandemic was significantly linked with increases in anxiety-related symptoms not found pre-pandemic, including an inability to stop or control worrying (F = 14.666, p < .001, η2p = 0.013) and worrying too much (F = 18.433, p < .001, η2p = 0.017).

Conclusions

These results have implications for pharmacy administrators and policymakers seeking to understand and limit adverse mental health outcomes within pharmacy during times of crisis.

Knowledge, Perceptions, and Readiness of Telepharmacy among Hospital Pharmacists in Saudi Arabia

Telepharmacy is a technology-based service that provides promoted services such as counseling, medication administration and compounding, drug therapy monitoring, and prescription review. It is unclear whether hospital pharmacists possess the necessary knowledge, attitudes, and willingness to practice telepharmacy. The current study sought to investigate Saudi Arabian hospital pharmacists' understanding, attitudes, and level of preparedness for telepharmacy services. A total of 411 pharmacists responded to the survey. Only 43.33% of the respondents agreed that telepharmacy is available in Saudi Arabia and 36.67% of the respondents agreed that patients in rural areas can have more medication access and information via telepharmacy. Only 29.33% of pharmacists agreed that telepharmacy improves patient medication adherence, and about 34.00% of the pharmacists agreed that telepharmacy saves patients money and time by eliminating the need for them to travel to healthcare facilities. This research found that hospital pharmacists were unsure of their level of knowledge, their attitude toward telepharmacy, and their willingness to incorporate it into their future pharmacy practices. To ensure that tomorrow's pharmacists have the skills they need to provide telepharmacy services, telepharmacy practice models must be incorporated into the educational programs that prepare them.

Developing a telepharmacy programme with home medication dispensing and informed delivery in a tertiary hospital: description of the model and analysis of the results

OBJECTIVES

This study aimed to describe the actions taken to implement a telepharmacy programme with home medication dispensing and informed delivery in an outpatient pharmaceutical care unit of a tertiary hospital, where approximately 5000 patients are treated per year. It also aimed to substantiate the applicability and benefits of the programme through analysing the findings and measuring patient satisfaction.

METHODS

We identified the operational, logistical, technological and legal needs, as well as the need for training, information and coordination with the care team and patient associations. A standard operating procedure was developed which described the home dispensing model and the profile of patients eligible for telepharmacy. Care activity was evaluated, between the months of July 2020 and January 2021; and a survey was conducted to measure patient satisfaction based on the Enopex project, a cross-sectional observational study of patients who used telepharmacy services during the COVID-19 lockdown period in Spain.

RESULTS

A total of 2536 medication deliveries were made over 144 working days, with a mean of 18 (standard deviation (SD): 6) deliveries per day, and a total of 2854 dispensings (1.1 drugs per delivery). In total, 197 different types of pharmaceutical formulations were delivered, corresponding to 123 active ingredients. The distance and time avoided during the study period totalled 1 05 624 km and 1 09 452 min (76 days), whereby the median distance and time saved per patient were 66 (interquartile range (IQR):122 km and 90 (IQR:90) minutes, which represents an approximate carbon footprint reduction of 25 kg of CO₂ per patient and 16.5 tonnes in total. The satisfaction survey conducted, completed by 134 patients, revealed high satisfaction with the pharmacy service of 9.88 points out of 10.

CONCLUSIONS

The SARS-CoV-2 pandemic (COVID-19) has provided the pharmacy service with an opportunity to develop and implement a telepharmacy programme that benefits patients, which has enabled better organisation of the unit and greater accessibility for patients attending in person. It is a replicable method that is applicable in other pharmacy services with similar characteristics and requirements.

[Patient participation through active listening. About the remodeling of an extractions service]

BACKGROUND AND OBJECTIVE

From listening to patients there arises the possibility of improving both the care and the health infrastructure that users frequent. Our purpose of study was to explore the perception of users about the means and the care received involved in a hospital service through active listening, and to evaluate the satisfaction perceived after the opening of the renovated area.

METHODS

A mixed methodology evaluative investigation was carried out within the context of the Extraction Service of the Costa del Sol Hospital, using qualitative methodology to assess the perception of users, and quantitative methodology through a satisfaction survey to identify the change after remodeling of the area.

RESULTS

Through a qualitative approach, improvements have been identified in terms of the internal and external infrastructure of the center, highlighting the need to personalize spaces depending on the profile of the patient attended. In evaluating the impact after remodeling the area, patients have a higher overall satisfaction both from the healthcare professionals who attend them and from the healthcare center.

CONCLUSIONS

Through the use of a mixed methodology, useful information has been incorporated for a project to improve a hospital infrastructure, and a subsequent evaluation of the positive impact on the satisfaction perceived by users after remodeling.