Telepharmacy: A New Paradigm for Our Profession

Abstract

Telepharmacy is a rapidly growing area of communication within pharmaceutical care delivery, especially in rural areas. The purpose of this literature review is to determine how telepharmacy is currently being practiced within community and ambulatory pharmacy settings, its effectiveness, and how it is being regulated across the United States. A literature review was performed using PubMed, Ovid MEDLINE, and the Google search engine. State-specific rules were researched using board of pharmacy and legislative online resources. Telepharmacy has been successfully implemented within community pharmacy settings through the creation of remote dispensing sites. The increasing focus of state regulations on telepharmacy services and practices shows the growth and acceptance of this modality of pharmacy practice. There is wide variation among state regulations pertaining to the setup and operation of telepharmacies. Trends in telemedicine show that telepharmaceutical care is likely to continue to expand as it allows for a better allocation of resources and access to more patients. However, research needs to be conducted to specifically analyze the value and place for telepharmacy services.

Leveraging telecommuting pharmacists in the post–COVID-19 world

“…Telepharmacy is primarily used in community, hospital, and ambulatory care settings to augment pharmacist coverage in rural and medically underserved areas. [20][21][22][23] Outcomes associated with telepharmacy services, particularly when combined with on-site pharmacy services, have been positive and include decreased medication errors, decreased order processing time, improved nursing satisfaction (because of the former), increased documentation of pharmacist interventions, and improved access to care. [21][22][23][24][25]…”

“…On-demand telepharmacy services most suitable for delivery by telecommuters include medication therapy management, prospective medication order review, in-process checks for compounded sterile preparations, visual inspection of medications before dispensing, pharmacotherapeutic consultations, drug information, medication reconciliation, and medication adherence activities. [20][21][22][23]27 Other, more advanced pharmacy services, such as antimicrobial stewardship and intensive care unit sedation protocol management, have been delivered successfully via telepharmacy and could also be performed by telecommuters. 21 Integrating telecommuters into existing staffing models could potentially help pharmacies expand clinical services.…”

Evaluation of Telepharmacy Services in Light of COVID-19

“…4,5 In this regard, telemedicine, which is the provision of remote health care services using information technology tools such as smartphones, telephones, and mobile wireless devices, has achieved much more attention during the pandemic since it reduced the risk of COVID-19 transmission by minimizing in person contact among individuals. [6][7][8] This includes telepharmacy, which refers to providing remote pharmacist services, with a spatial distance between the pharmacist and the patients as the consumers of health services. 6,9 The effectiveness of telepharmacy was demonstrated as a mean to prompt asthma control, 10 and a tool to reduce adverse drug events in hospitals.…”

“…[6][7][8] This includes telepharmacy, which refers to providing remote pharmacist services, with a spatial distance between the pharmacist and the patients as the consumers of health services. 6,9 The effectiveness of telepharmacy was demonstrated as a mean to prompt asthma control, 10 and a tool to reduce adverse drug events in hospitals. 11 However, no significant difference in dispensing error rates across pharmacies with and without remote services was reported.…”

Rural–Urban Disparities in Access to Medicaid-Contracted Pharmacies in Washington State, 2017

“…Telepharmacy has also been shown to decrease health care use among rural veterans at high risk for adverse drug events and medication reconciliation discrepancies ( 32 ). Despite the potential for improving access to care in medically underserved areas, only about half of the states in the United States have passed legislation allowing telepharmacy, and regulations vary by state ( 33 ). Addressing issues such as reimbursement, licensing, and data security ( 33 ) will be important for expanding pharmacy services in the United States.…”