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

Abstract

ObjectivesThis 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.MethodsWe 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.ResultsA 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.ConclusionsThe 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.

Perception and Willingness to Use Telepharmacy Among the General Population in Jordan

“…8,9 It has been also showed to reduce hospital admissions during the pandemic, diminish burden on hospitals, and save time to patients and staff. 4,10,11 Telepharmacy allows for a personalized interaction between the patient and the pharmacist to include patient-care services such as counseling, assessment of medication adherence, as well as comprehensive medication review. 2,8,12 Jordan, a developing Middle Eastern country, had a population of around 10.2 million in 2020, with an average age of 22.8 and a slightly higher male-to-female ratio.…”

Home delivery of medications: Community pharmacists' perspectives on the pros and cons of the service

“…Therefore, there is a need for studies with a stronger methodological rigor to thoroughly address this regard. Despite the fact that the implementation of home delivery of medications is associated with several pros, such as treatment continuity, economic savings, decongestion of the healthcare centers, avoiding traveling expenses, saving patients' time, and enhancing the quality of life (10,17), there are potential drawbacks that should be highlighted. First, implementing a home drug delivery service without integrating it with the telepharmacy system, compromises the optimal provision of the pharmaceutical care (2).…”

“…A recent study found that patients on maintenance medications through home delivery are more likely to take them as prescribed for conditions like diabetes, hypertension, and dyslipidemia ( 13 ). However, previous studies that investigated the benefits of home delivery services were self-administered questionnaires susceptible to social desirability bias ( 10 , 12 , 14 – 17 ). Therefore, there is a need for studies with a stronger methodological rigor to thoroughly address this regard.…”

“…First, implementing a home drug delivery service without integrating it with the telepharmacy system, compromises the optimal provision of the pharmaceutical care ( 2 ). Second, home drug delivery services might be accompanied by a risk of breaching patients' confidentiality, especially those suffering from medical conditions with a greater social stigma or disability ( 17 ). It is noteworthy, that in Jordan, a Middle Eastern developing country, that is experiencing an economic meltdown, implementing home drug delivery is still lagging behind ( 18 ).…”

“…While tackling a patient-centered approach, considerations should be made particularly in vulnerable sick and disabled patients, the elderly, and many other patients where a visit to the pharmacy is not a simple task ( 14 , 20 ). While during the pandemic several studies were investigating the implementation of home delivery, and other telehealth services, they were all conducted from patients' perspectives, and none of these studies the perception of community pharmacists toward this practice ( 10 , 14 – 17 ). Investigating community pharmacists' perception and willingness of adopting this service is necessary to ensure their effective involvement and awareness of the pros and cons of this service.…”