Chong Rachel Lai Kay, Chan Andrew Siang Ee, Chua Crystal Min Siu, Lai Yi Feng
NUS Pharmacy and Pharmaceutical Sciences, Singapore, Singapore.
MOH Office for Healthcare Transformation, Singapore, Singapore.
J Med Internet Res. 2025 May 7;27:e57129. doi: 10.2196/57129.
Pharmaceutical care has expanded, with telehealth playing a key role, especially during the COVID-19 pandemic. Despite global growth, existing reviews focus on specific settings or conditions, highlighting the need for broader research on public health topics and comparative studies to evaluate the effectiveness, preferences, and cost of telehealth interventions in pharmacy practice.
The aim of this study was to unify 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.
The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework was used to guide this review. In total, 4 databases were searched for relevant studies: PubMed, CINAHL, Web of Science, and Cochrane Library. Title, abstract, and full-text screening was performed, and 18 reviews met the selection criteria. The search period was from August 1, 2012, to December 22, 2024. The quality of the reviews was assessed using a 5-point Likert scale and a GRADE-CERQual scale.
Based on the identified reviews, telehealth interventions were categorized into teleconsultation, telemonitoring, telecollaboration, and telesupport. Teleconsultation was the most frequently used. 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 used to facilitate telecollaboration, such as telephone, fax, electronic messaging, shared electronic records, and videoconferencing. 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. Our results show a strong push to integrate telehealth into future pharmacy practice, with the United States leading the way in adoption, demonstrating increased care access, quality, and patient safety. In Singapore, telephone consultations have been commonly used in hospitals, though community settings lack widespread adoption. However, the growing digital literacy of older adults and innovations like chatbots and telemonitoring present opportunities to expand telehealth services. To align with this shift, pharmacy education should invest in enhancing formative training by incorporating telehealth training, ensuring future pharmacists are prepared for this evolving practice, applicable to regions with similar contexts.
Telehealth has shown promise in improving overall outcomes in pharmacy practice. While many countries have made strides, particularly in hospital settings, there remains an opportunity for greater adoption in community health care, driven by innovations like telemonitoring and digital literacy among older adults. The findings from this study can be used to inform future implementation of telehealth interventions in pharmacy in Singapore and other regions or cities with similar contexts.
药学服务已经得到扩展，远程医疗发挥着关键作用，尤其是在新冠疫情期间。尽管在全球范围内有所发展，但现有的综述主要聚焦于特定环境或病症，这凸显了开展更广泛的公共卫生主题研究以及比较研究的必要性，以便评估远程医疗干预在药学实践中的有效性、患者偏好和成本。
本研究旨在整合现有关于远程医疗对未来药学实践影响的文献，并分析当前药学实践中已经实施的相关内容，以便提出建议。
采用PRISMA（系统评价与Meta分析优先报告条目）框架来指导本综述。总共检索了4个数据库以查找相关研究：PubMed、CINAHL、科学网和考克兰图书馆。进行了标题、摘要和全文筛选，有18篇综述符合入选标准。检索时间段为2012年8月1日至2024年12月22日。使用5点李克特量表和GRADE-CERQual量表评估综述的质量。
基于所纳入的综述，远程医疗干预被分为远程会诊、远程监测、远程协作和远程支持。远程会诊是最常用的。在远程会诊和远程监测中，电话最为常见，而在远程支持中，移动应用、网络应用或计算机应用最为常见。最常采用多种方法相结合来促进远程协作，如电话、传真、电子信息、共享电子记录和视频会议。所纳入的综述依据健康结局、医院再入院率、患者安全、依从性、满意度、药剂师短缺以及医疗服务质量和可及性进行评估。与传统药学实践相比，药学领域中远程医疗的应用总体上使整体结局得到了改善。我们的结果表明，将远程医疗整合到未来药学实践中的趋势强劲，美国在采用方面处于领先地位，显示出医疗服务可及性、质量和患者安全的提升。在新加坡，电话会诊在医院中普遍使用，但在社区环境中尚未广泛采用。然而，老年人数字素养的提高以及聊天机器人和远程监测等创新技术为扩大远程医疗服务提供了机会。为顺应这一转变，药学教育应通过纳入远程医疗培训来加强形成性培训，确保未来的药剂师为这种不断发展的实践做好准备，这适用于具有类似背景的地区。
远程医疗在改善药学实践的整体结局方面显示出前景。虽然许多国家已经取得了进展，特别是在医院环境中，但在社区医疗保健中仍有更大的采用空间，这受到远程监测和老年人数字素养等创新技术的推动。本研究的结果可用于为新加坡及其他具有类似背景的地区或城市未来在药学中实施远程医疗干预提供参考。
