Telepharmacy

Telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist.

seminar presentation

1. TELEPHARMACY NAME:- SWADHIN ROUTRAY REGD. NO. :- 2161611005 M.PHARM(PHARMACEUTICS) SUB CODE:- MPH106S/A SEMINAR ON DRUG DELIVERY SYSTEM

2. INTRODUCTION TYPES OF TELEPHARMACY WORKING INFORMATION TECHNOLOGY CONSIDERATION ADVANTAGES DISADVANTAGES ARTICLES REFERENCES CONTENTS

3. INTRODUCTION Telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. It includes and retains the active role of the pharmacist as the primary health care provider in the delivery of pharmacy services. Telepharmacy services include drug therapy monitoring, prior authorization and refill authorization for prescription drugs, and monitoring of formulary compliance . (1)

4. TYPES OF TELEPHARMACY There are 4 types of Telepharmacy: Inpatient (remote order-entry review) Remote dispensing (retail/outpatient/discharge) 3 . IV admixtures 4. Remote counseling

5. 1 ) Inpatient (remote order-entry review) Inpatient t elepharmacy refers to a pharmacist at a remote location performing remote order-entry services for an inpatient pharmacy at a hospital. The remote pharmacist reviews medication orders before the hospital staff administers the drugs to the patient . USE- Real time medication review (2 ) 2) Remote dispensing (retail/outpatient/discharge) A remote-dispensing site or retail community t elepharmacy is a licensed brick-and-mortar pharmacy staffed by a certified pharmacy technician. A pharmacist supervises the technician, reviews prescriptions and performs his or her duties from a remote location via technology . USE- Discharge pharmacy settings, access to prescription medicines (2 )

6. 3) IV admixture The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) defines IV admixture as, ‘ the preparation of pharmaceutical product which requires the measured addition of a medication to a 50ml or greater bag or bottle of intravenous fluid . ‘In layman’s terms, IV admixture is the mixture of IV solution administered to patients in a hospital setting . 4) Remote counseling Remote- patient counseling equates to pharmacists providing patient counseling and interactive video session, or by some means through telecommunications . USE- consult and provide a variety of pharmacy-care services ( 2)

7. SCHEMATIC OF TELEPHARMACY WORKING

8. WORKING OF TELEPHARMACY

9. TECHNOLOGICAL INFORMATION, ADVANTAGES, DISADVANTAGES Computer:- QS-1, Midco data, PDX, Rx30, IsoRx Patient medication profile Screening for drug interaction Generating prescription via labels with patient instruction. Billing third party payers ADVANTAGES:- Effective patient counseling Reduced workload and errors Improve timeliness for medication delivery DISADVANTAGES:- Operational difficulties Downtime system failure and inflexibility Literacy rate and diversity in languages (3)

10. ARTICLE:-1 EVALUATION OF TELEPHARMACY SERVICES IN LIGHT OF COVID-19 Md Ibrahim et al. 2019 aimed to evaluate the predictors for effective telepharmacy services by exploring factors associated with pharmacist interventions and dispensing errors in community pharmacies . Pharmacy interventions and dispensing errors across pharmacies with and without telepharmacy services were monitored during the COVID-19 outbreak in the United Arab Emirates. This was a prospective observational study conducted for 4 months (March 2020–July 2020) in community pharmacies in the UAE during the outbreak. G*Power software20 was used for sample size calculation (power = 0.8, a £ 0.05, effect size = 0.8 ). (4)

11. Association of COVID-19–Related Recommendation Categories (n = 79,253) With Pharmacy Status (With vs. Without Remote Services)

12. RESULT C ontact the nearest testing center (adjusted odds ratio [AOR ] = 7.93), maintain home quarantine (AOR= 5.64 ), and take paracetamol for fever (AOR= 3.53), all were significant results (p < 0.05). Rates of medication dispensing errors (MDEs ) and its subcategories, prescription-related errors, and pharmacist counseling errors across pharmacies with telepharmacy versus those without remote services were ( 15.81% vs . 19.43%, p < 0.05), (5.38% vs. 10.08%, p < 0.05), and (10.42 % vs. 9.35%, p > 0.05), respectively. However, pharmacies with telepharmacy were more likely to include wrong patient errors (AOR= 5.38, p < 0.05).

13. ARTICLE:- 2 CURRENT PRACTICES AND STATE REGULATIONS REGARDING TELEPHARMACY IN RURAL HOSPITALS M. Casey et al. 2012 purposed telepharmacy practices in rural hospitals of several states were examined, and relevant policies and state laws and regulations were analyzed, along with issues to be addressed as the use of telepharmacy expands. Telepharmacy initiatives in rural hospitals were identified through a survey of the 50 state offices of rural health. It was analyzed to identify and to assess whether state laws and regulations followed by the NABP and the American Society of Health- System Pharmacists apply to telepharmacies . (5)

14. RESULT North Dakota- North Dakota has historically been the most active in addressing telepharmacy regulatory issues. Montana - The rules are not specific to hospitals. To be licensed as a remote telepharmacy site, a site must be located beyond a 10-mile radius of an existing pharmacy. South Dakota- They allow a hospital pharmacy to contract with a “central pharmacy” to provide after hours pharmacy services via electronic. Texas- Hospitals with 100 or fewer beds must have a pharmacist on site 24 hours a day, seven days a week under continuous onsite supervision.

15. ARTICLE:-3 TELEPHARMACY AND QUALITY OF MEDICATION USE IN RURAL AREAS Mitchell Haynes et al. 2020 obtained dispensing data for the first 18 months of operation from 3 telepharmacies and 3 traditional pharmacies located in the upper Midwest . They evaluated adherence for noninsulin diabetes medications, renin-angiotensin system antagonists, and statins, as well as inappropriate use of high-risk medications in older adults. All metrics were calculated using Medicare Part D specifications; they estimated the differences between telemedicine pharmacies and traditional pharmacies using generalized linear regression . (6)

16. RESULT A total of 2,832 patients contributed 4,402 observations to the quality measures. After covariate adjustment, we observed no significant differences between telepharmacies and traditional pharmacies for noninsulin diabetes medications, renin-angiotensin system antagonists , statins, and high-risk medications. However, statin use in persons with diabetes was higher in telepharmacies than traditional pharmacies.

17. REFERENCES Margolis, S, Ypinazar , V.A , et al.  Tele-pharmacy in remote medical practice: the Royal Flying Doctor Service Medical Chest Program.  Rural Remote Health. 2008;8(12): 937 . Fatima, ROOHI , Ahmed, SANA, et al.   Telepharmacy.  European Journal of Biomedical and Pharmaceutical Sciences. 2018;5(3): 176-182. Yellowlees P. Successfully developing a telemedicine system. Journal of Telemedicine and Telecare 2010;11(2):331-5 . Smith AC, Thomas E, Snoswell CL, Haydon H, et al . Evaluation of telepharmacy services in light of covid-19. J Telemed Telecare 2020;26(1):309–313 . Casey M, Moscovice I, Davidson G . Current practice and state regulation regarding telepharmacy in rural hospital. J Rural Health . 2012; 22(1):321-30 . Mitchell H , Peterson GM, Jackson SL. Telepharmacy and quality of medication use in rural areas. A narrative systematic review . Int. J Pharm Pract. 2020;28(1):3–12.