Telehealth Interventions in Pharmacy Practice: A Systematic Review of Reviews and Recommendations for Singapore (Preprint)

Abstract

Telehealth services have been increasingly adopted in recent years with advancement in technology and the Covid-19 pandemic being major drivers of this change.

The aim of this systematic review of reviews was to consolidate existing literature on the impact of telehealth on future pharmacy practice and to analyze those already implemented in current pharmacy practice, with the objective of providing recommendations on how these interventions may be applied in the context of Singapore.

The PRISMA framework was used to guide this review. Four databases were searched for relevant studies: PubMed, CINAHL, Web of Science, Cochrane Library. Title, abstract and full text screening was performed and 18 reviews met the selection criteria. The search period was from April to August 2023. The quality of the reviews was assessed using a 5-point Likert scale and a GRADE-CERQual scale.

Based on the 18 identified reviews, telehealth interventions were categorized into: Teleconsultation, Telemonitoring, Telecollaboration, Telesupport. Teleconsultation was the most frequently utilized, followed by a combination of interventions, telesupport, telemonitoring and telecollaboration. Telephones were most common in teleconsultations and telemonitoring, while mobile, web or computer applications were most frequent in telesupport. A combination of methods was most commonly used to facilitate telecollaboration (eg. telephone, fax, electronic messaging, shared electronic records, video conferencing). The identified reviews were evaluated by health outcomes, hospital readmission rates, patient safety, adherence, satisfaction, pharmacist shortage, and quality and access to care. The use of telehealth in pharmacy has generally seen an improvement in overall outcomes compared to traditional pharmacy practice.

Telehealth has shown promise in improving overall outcomes in pharmacy practice. The findings from this study can be used to inform future implementation of telehealth interventions in pharmacy, including in the context of Singapore.