Assessing the Effectiveness of Telepharmacy Services in Rural and Underserved Areas
 
Ahmed Rawsh Alanazi1*, Abdulsalam Ali Alamri2, Abdulaziz Mufadhi Alanazi3, Mohammed Saleh Alqarni4, Ahmed Mohammed Abdullah5
1,3,5 Pharmacy Technician, Prince Sultan Military Medical City, Riyadh, KSA
2,4 Pharmacist, Prince Sultan Military Medical City, Riyadh, KSA
1 Email: A67w@hotmail.com  
Abstract - This study evaluates the effectiveness of telepharmacy services in improving healthcare delivery in rural and underserved areas. Utilizing a mixed-methods design, both quantitative and qualitative data were collected over a 12-month period. The study involved 200 patients who used telepharmacy services, providing remote access to pharmacists for medication dispensing, consultations, and patient education. Quantitative data included patient surveys on medication adherence and satisfaction, along with medication records to assess dispensing errors. Qualitative data were obtained through interviews with patients and pharmacists to explore their experiences.
Results indicated a significant increase in medication adherence rates from 60.0% to 85.0% post-telepharmacy implementation. Patient satisfaction scores across various domains improved notably, with mean scores for access to pharmacists, quality of consultations, and overall satisfaction showing significant enhancements (p < 0.001). Additionally, there was a substantial reduction in medication errors, with dispensing errors decreasing from 15.0% to 5.0% (p < 0.01) and prescription errors from 10.0% to 4.0% (p < 0.05). Economic analysis revealed a decrease in healthcare costs per patient from $2000 to $1500, along with a reduction in hospitalizations per 1000 patients from 50 to 30 (p < 0.01).
These findings are consistent with previous studies and underscore the potential of telepharmacy as a cost-effective and efficient solution to healthcare disparities in rural and underserved regions. Despite technological and regulatory challenges, telepharmacy represents a promising approach to enhancing healthcare access, improving clinical outcomes, and achieving significant cost savings in rural healthcare systems.
Keywords: Telepharmacy, Rural Healthcare, Medication Adherence, Patient Satisfaction, Medication Errors, Healthcare Costs
INTRODUCTION
A new field known as telepharmacy uses telecommunications generation to provide sufferers in underprivileged and rural locations with pharmaceutical care. Telepharmacy offerings had been first evolved as a way to address the dearth of chemists in rural regions. Today, they provide a extensive variety of services, such as the transport of medications, patient counselling, and medical consultations. Geographical boundaries are to be removed so that it will assure that each one patients, wherever they'll be, have access to essential pharmaceutical services (Poudel et al., 2017). Telepharmacy has the capability to completely remodel the way healthcare is brought by way of bridging the space between rural and concrete healthcare infrastructures as generation develops.
Due to a loss of healthcare centers and employees, receiving healthcare offerings can be extraordinarily hard in rural and underserved areas. By permitting remote get admission to to chemists who can offer medicine control, patient education, and scientific assistance, telepharmacy tackles those troubles. This is especially essential in rural areas in which drug-associated problems and continual ailments are not unusual (Dunlap and Jankovitz, 2014). Patients in these areas can gain spark off and specific pharmaceutical care by way of the use of telepharmacy, that can beautify fitness outcomes and reduce the stress on local healthcare structures.
Due to a lack of healthcare centers and employees, receiving healthcare services may be extraordinarily hard in rural and underserved areas. By allowing far off get right of entry to to chemists who can offer medication control, affected person training, and clinical help, telepharmacy tackles these issues. This is mainly crucial in rural areas wherein drug-associated troubles and continual ailments are commonplace (Dunlap and Jankovitz, 2014). Patients in these regions can achieve set off and particular pharmaceutical care by means of the usage of telepharmacy, which can decorate health outcomes and reduce the pressure on regional healthcare systems.
Telepharmacy gives advantages past smooth access to clinical services. According to studies, telepharmacy can increase affected person satisfaction, decrease remedy mistakes, and enhance drug adherence (Poudel et al., 2017). Furthermore, by means of allowing chemists to supervise larger patient populations and paintings remotely with different healthcare experts, telepharmacy promotes the greater effective use of healthcare assets. Patients in underserved and rural regions may benefit from higher coordinated treatment and stepped forward health results because of this cooperative method (North Dakota State University, 2020).
Telepharmacy has a lot of capability, however it also has numerous drawbacks and problems. These include challenges with policies and compensation, as well as technological hurdles such the absence of infrastructure and internet connectivity in a few far off places. Furthermore, reluctance to apply telepharmacy offerings can get up from concerns concerning the same old of care and the necessity of in-man or woman conferences with scientific specialists (Poudel et al., 2017). To guarantee that telepharmacy can be correctly included into the healthcare device, legislators, healthcare carriers, and groups have to work together to deal with these troubles.
The purpose of this study is to evaluate how well telepharmacy services can enhance the provision of healthcare in underprivileged and rural locations. It will examine a number of telepharmacy-related topics, such as how it affects patient outcomes, drug adherence, and healthcare expenses. The study will also look at the difficulties and roadblocks in putting telepharmacy services into practice and make suggestions on possible ways to get around them. This study aims to demonstrate the possibility of telepharmacy as a workable remedy for healthcare inequities in underserved and rural areas by offering a thorough assessment of the practice.
LITERATURE REVIEW
The amount of studies on telepharmacy has expanded substantially in current years, that is indicative of the era's developing reputation and affect on healthcare delivery. In the beyond, research has basically concentrated on the viability and reputation of telepharmacy services in underserved and rural areas. For instance, North Dakota changed into a number of the first states to utilise telepharmacy, beginning a statewide initiative in 2002. Because of this application's potential to supply secure and efficient pharmaceutical care in far flung areas, telepharmacy is anticipated to be widely followed within the US (North Dakota State University, 2020).
Numerous investigations have seemed into how telepharmacy affects affected person effects and drug adherence. For instance, Poudel et al. (2017) observed that telepharmacy services substantially extended sufferers' adherence to medication after they lived in far off places. The greater accessibility to chemists, who presented frequent follow-usaand counselling classes through telecommunication structures, changed into credited with this improvement. Furthermore, sizeable enhancements had been seen in affected person outcomes like diabetes control and blood pressure manage, underscoring the medical blessings of telepharmacy (Poudel et al., 2017). Numerous investigations have appeared into how telepharmacy impacts affected person consequences and drug adherence. For example, Poudel et al. (2017) found that telepharmacy offerings substantially increased patients' adherence to remedy once they lived in far off places.
The greater accessibility to chemists, who offered frequent comply with-united statesand counselling periods through telecommunication systems, was credited with this development. Furthermore, tremendous enhancements have been visible in affected person outcomes like diabetes control and blood pressure control, underscoring the scientific benefits of telepharmacy (Poudel et al., 2017). Telepharmacy has been shown to be value-powerful via monetary critiques, mainly in remote healthcare settings. Ulrich and Kumaran (2016), for example, carried out a fee-benefit evaluation that confirmed how telepharmacy services should lower healthcare prices with the aid of lowering the want for physical pharmacy infrastructure and permitting pharmacists to use their time extra successfully.
The observe additionally located that telepharmacy ought to reduce the chance of costly medication-associated facet effects, which provides to its economic advantages. These results imply that telepharmacy affords rural healthcare structures with a financially viable alternative in addition to improving access to care (Ulrich Kumaran, 2016). The use of telepharmacy services is hampered by means of a variety of of factors in spite of its advantages. Technological obstacles could make it extra hard to provide telepharmacy services efficiently, such as bad virtual infrastructure and spotty internet access in some foreign places.
Reimbursement and regulatory concerns additionally continue to be major roadblocks. For instance, varying state legal guidelines governing telepharmacy may make it greater difficult for it to be adopted and incorporated into current healthcare structures (Poudel et al., 2017). Standardised rules and processes also are required to assure the calibre and reliability of telepharmacy services. To put off these barriers and offer a telepharmacy-friendly surroundings, legislators, healthcare professionals, and generation builders have to work collectively (Poudel et al., 2017).
MATERIALS AND METHODS
Research Plan
This examine evaluated the efficacy of telepharmacy offerings in underprivileged and rural regions using a blended-techniques design that used quantitative and qualitative strategies. While patient and chemist interviews produced qualitative information, patient surveys and medicine facts yielded quantitative records. Over a 12-month length, the have a look at turned into performed to enable thorough records accumulating and analysis.
Examine the Population
Patients the usage of telepharmacy services from underserved and rural regions made up the study population. Adults who had been prescribed medicine via a telepharmacy provider and were utilising the service for at the least three months met the inclusion standards. Patients who did not speak the language well or had cognitive issues that made it not possible for them to present informed permission were excluded.
Data Gathering
Patients have been given standardised questionnaires to finish with a purpose to achieve records on medication adherence, telepharmacy service pleasure, and perceived fitness results. In order to evaluate the accuracy and frequency of prescription shelling out mistakes, medication records have been additionally examined. Semi-structured interviews have been finished with chemists and patients to obtain a deeper knowledge of their viewpoints and experiences approximately telepharmacy.
Intervention
Offering telepharmacy offerings, inclusive of on-line consultations, remote medication meting out, and patient education classes, turned into the look at's intervention. Telecommunication equipment and steady video conferencing platforms had been used to provide these offerings. Pharmacists accompanied up with patients on a frequent foundation to address any drug-associated issues, assessed adherence, and offered counselling on remedy use.
Information Analysis
In order to decide descriptive records for medicine adherence costs and patient satisfaction rankings, along with method and trendy deviations, quantitative facts have been analysed the use of statistical software. Different affected person groups' consequences have been as compared the use of inferential records, which includes chi-square and t-tests. The implementation and efficacy of telepharmacy offerings have been examined by using the topic evaluation, coding, and transcription of qualitative records obtained from interviews.
Ethical Considerations
Ethical acclaim for the look at was acquired from the Institutional Review Board (IRB) of the affiliated college. All contributors supplied knowledgeable consent previous to participation, and their confidentiality and anonymity have been maintained for the duration of the observe. Data were securely stored and accessed simplest through the research group to make sure the privateness and protection of player facts.
RESULTS AND DISCUSSION
Table 1: Patient Demographics
Demographic Variable
Number of Patients (n=200)
Percentage (%)
Age Group (years)
 
 
18-29
40
20.0
30-49
70
35.0
50-64
60
30.0
65+
30
15.0
Gender
 
 
Male
90
45.0
Female
110
55.0
 
Patients aged 30-49 years accounted for 35.0% of all telemedicine users, followed by those aged 50-64 years (30.0%). Patients were more female (55.0%) than male patients (45.0%).
Table 2: Medication Adherence Rates
Adherence Measure
Pre-Telepharmacy (%)
Post-Telepharmacy (%)
p-value
Medication Adherence (MA)
60.0
85.0
<0.001
Patients with Adherence ≥ 80%
50.0
75.0
<0.001
 
Medication adherence rates increased from 60.0% to 85.0% (p < 0.001) once telepharmacy services were implemented. Furthermore, from 50.0% to 75.0% (p < 0.001), more patients had adherence rates of 80% or greater.
Table 3: Patient Satisfaction Scores
Satisfaction Domain
Mean Score Pre-Telepharmacy
Mean Score Post-Telepharmacy
p-value
Access to Pharmacist
3.2
4.5
<0.001
Quality of Consultation
3.4
4.6
<0.001
Overall Satisfaction
3.3
4.7
<0.001
 
Following telepharmacy, affected person satisfaction degrees notably elevated in a number of dimensions. Positive reception of telepharmacy offerings changed into indicated by using giant increases in the suggest scores for quality of consultation, availability to a chemist, and usual satisfaction (p <0.001 for all areas).
Table 4: Medication Error
Type of Error
Pre-Telepharmacy (%)
Post-Telepharmacy (%)
p-value
Dispensing Errors
Administration Errors
5.0
<0.01
Prescription Errors
10.0
4.0
<0.05
Administration Errors
8.0
3.0
<0.05
 
Medication mistakes have decreased as a result of the introduction of telepharmacy services. Errors in prescription writing dropped from 10.0% to 4.0% (p <0.05), errors in management from 8.0% to 3.0% (p,0.05), and mistakes in dispensing fell from 15.0% to 5.0% (p< 0.01).
Table 5: Economic Impact
Economic Measure
Pre-Telepharmacy
Post-Telepharmacy
p-value
Healthcare Costs per Patient ($)
2000
1500
<0.01
Number of Hospitalizations per 1000 Patients
50
30
<0.01
Cost Savings from Reduced Errors ($)
50
500
<0.01
 
Healthcare prices consistent with patient were substantially decreased with the aid of telepharmacy offerings, from $2000 to $1500 (p<0.01). Additionally, the variety of hospitalisations consistent with 1000 patients reduced from 50 to 30 (p<0.01), which helped save general costs via $500 due to a lower in remedy mistakes.
DISCUSSION
The present study's outcomes are consistent with earlier investigations that underscore the beneficial influence of telepharmacy on medication compliance. According to our results, adherence rates increased significantly from 60.0% to 85.0%. This is in line with the findings of Poudel et al. (2017), who found that telepharmacy services improved adherence in a similar way by providing virtual counselling and regular follow-ups. This is a result of telepharmacy's ability to provide more individualised care and greater accessibility to pharmacists. These higher adherence rates were also probably influenced by the ease of remote consultations and the removal of travel obstacles for patients in rural locations.
The look at's patient satisfaction scores validated terrific improvements in a number of areas, which include the supply of chemists and the calibre of consultations. These consequences are regular with a have a look at by Clifton et al. (2020), which determined that patients were surprisingly happy with telepharmacy offerings due to the progressed care pleasant and powerful avenues for communique. Furthermore, our research showed a noteworthy decline in drug errors, with shelling out errors falling from 15.0% to five.0%. This confirms in advance studies via Clifton et al. (2020), who also saw a drop in remedy errors following using telepharmacy. They attributed this lower to chemists' far flung tracking and verification, which improves the precision and safety of medication distribution.
Ulrich and Kumaran's (2016) findings are corroborated by the economic benefits seen in our analysis, which include lower healthcare expenses per patient and fewer hospitalisations. Their cost-benefit study showed that telepharmacy avoids expensive medication-related complications in addition to lowering infrastructure expenses. According to our research, hospitalisations and healthcare expenditures decreased from $2000 to $1500 per patient, suggesting that telepharmacy can result in substantial financial savings for healthcare systems. These financial benefits along with better clinical results highlight telepharmacy's promise as a long-term and practical way to reduce healthcare inequities in neglected and rural areas.
CONCLUSION
The study concludes with sturdy evidence that telepharmacy services offer massive economic advantages and substantially beautify medication adherence, patient delight, and protection in underserved and rural locations. The results are consistent with earlier studies, displaying that telepharmacy can near the healthcare hole in rural areas by means of imparting effortlessly available, advanced pharmaceutical treatment. The extensive decreases in pharmaceutical mistakes and clinical costs emphasise its ability as an economical treatment. On the alternative hand, telepharmacy can not be successfully implemented until technological, governmental, and infrastructure issues are resolved. Telepharmacy is an essential a part of modern healthcare systems when you consider that, all things taken into consideration, it gives a capacity manner of improving healthcare outcomes and delivery for those residing in underserved and rural regions.
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