Systematic literature review of adopting eHealth in pharmaceutical care during COVID-19 pandemic: recommendations for strengthening pharmacy services

Objectives The study aimed to determine how eHealth was adopted in pharmaceutical care (PC), the outcome reported and the contextual factors. Design Systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sources Literature was searched in six databases including PubMed, Scopus, Medline, Web of Science, Science Direct and China National Knowledge Infrastructure. Eligibility criteria Studies which reported the usage experiences of eHealth in any aspects of PC by pharmacists during the COVID-19 pandemic, written in English or Chinese, and published in peer-reviewed journals between December 2019 and March 2022 were included. Opinion articles, conference abstracts, correspondence, letters and editorials were excluded. Data extraction and synthesis The literature search was completed on 15 April 2022. Two researchers independently conducted the literature search and extracted the data into an Excel table informed by the logic model with the key components of goals, input, activities, output and contextual factors. Results Forty-three studies were included in this review. During the COVID-19 pandemic, hospital pharmacists, community pharmacists and specialist pharmacists in 17 countries continued to educate, consult, monitor and manage the patients and the general public via phone calls, videoconferences, mobile applications, social media, websites and/or enhanced interoperability of electronic medical records. Assuring the continuity of pharmacy care, reduced need for hospital visits, and improved work accuracy and efficiency were the benefits of eHealth mostly reported. Contextual factors affecting the adoption of eHealth were multifaceted, prompting supporting actions at the levels of government, hospital/pharmacy, pharmacists and patients. Conclusion This study revealed the wide adoption of eHealth in PC during the pandemic and the emerging evidence for its importance. Proper adoption of eHealth will help reshape the mode of pharmacy services to ensure continuity, quality and efficiency of care amid the challenges of the pandemic. PROSPERO registration number CRD42022299812.

[1]  A. Alfaleh,et al.  Impact of COVID-19 on the 937 Telephone Medical Consultation Service in Saudi Arabia , 2022, International journal of telemedicine and applications.

[2]  R. Solimini,et al.  Ethical and Legal Challenges of Telemedicine in the Era of the COVID-19 Pandemic , 2021, Medicina.

[3]  Zhiling Li,et al.  Innovative Strategies and Efforts of Clinical Pharmacy Services During and After COVID-19 Epidemic: Experience from Shanghai Children’s Hospital , 2021, Risk management and healthcare policy.

[4]  Fuad H. Al-Ghamdi,et al.  Implementation of pharmacist-led tele medication management clinic in ambulatory care settings: A patient-centered care model in COVID-19 Era , 2021, Exploratory Research in Clinical and Social Pharmacy.

[5]  Maja Baretić,et al.  Healthcare Information Technology: Fast and Accurate Information Access vs. Cyber-Security , 2021, Int. J. E Serv. Mob. Appl..

[6]  Si-qian Zheng,et al.  The Establishment and Practice of Pharmacy Care Service Based on Internet Social Media: Telemedicine in Response to the COVID-19 Pandemic , 2021, Frontiers in Pharmacology.

[7]  Milena Kovačević,et al.  Telepharmacy service experience during the COVID‐19 pandemic in the Republic of Srpska, Bosnia and Herzegovina , 2021, Health & social care in the community.

[8]  Hani M. J. Khojah,et al.  Provision of pharmaceutical care to suspected high-risk COVID-19 patients through telehealth: a nationwide simulated patient study , 2021, BMC Health Services Research.

[9]  M. A. Al Ammari,et al.  Tele-pharmacy Anticoagulation Clinic During COVID-19 Pandemic: Patient Outcomes , 2021, Frontiers in Pharmacology.

[10]  Benita Wiatrak,et al.  Patients’ Habits and the Role of Pharmacists and Telemedicine as Elements of a Modern Health Care System during the COVID-19 Pandemic , 2021, Journal of clinical medicine.

[11]  L. Rus,et al.  The Particularities of Pharmaceutical Care in Improving Public Health Service during the COVID-19 Pandemic , 2021, International journal of environmental research and public health.

[12]  Nasrul Wathoni,et al.  Telepharmacy: A Potential Alternative Approach for Diabetic Patients During the COVID-19 Pandemic , 2021, Journal of multidisciplinary healthcare.

[13]  J. Kim,et al.  Impact analysis of virtual ambulatory transplant pharmacists during COVID‐19 , 2021, Journal of the American College of Clinical Pharmacy : JACCP.

[14]  Shin-Yu Lee,et al.  Evaluating the primary care clinical pharmacist visit transition to telehealth during the COVID‐19 pandemic by comparing medication related problems from telehealth visits and in‐person visits , 2021, Journal of the American College of Clinical Pharmacy : JACCP.

[15]  Ahmad Z. Al Meslamani,et al.  An emergency plan for management of COVID‐19 patients in rural areas , 2021, International journal of clinical practice.

[16]  J. Levitt,et al.  The pharmacist as a public health resource: Expanding telepharmacy services to address social determinants of health during the COVID-19 pandemic , 2021, Exploratory research in clinical and social pharmacy.

[17]  H. Elewa,et al.  Drive‐up INR testing and phone‐based consultations service during COVID‐19 pandemic in a pharmacist‐lead anticoagulation clinic in Qatar: Monitoring, clinical, resource utilization, and patient‐ oriented outcomes , 2021, Journal of the American College of Clinical Pharmacy : JACCP.

[18]  C. S. Kow,et al.  Pharmacist-patient communication amid COVID-19 pandemic: A review of available options and potential impact , 2021, British Journal of Pharmacy.

[19]  Andrew Allison,et al.  Providing essential clinical pharmacy services during a pandemic: Virtual video rounding and precepting , 2021, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[20]  S. Rotolo,et al.  Virtual medication tours with a pharmacist as part of a cystic fibrosis telehealth visit , 2021, Journal of the American Pharmacists Association.

[21]  R. Karasneh,et al.  Pharmacists’ experience, competence and perception of telepharmacy technology in response to COVID‐19 , 2021, International journal of clinical practice.

[22]  E. Mayo-Wilson,et al.  The PRISMA 2020 statement: an updated guideline for reporting systematic reviews , 2021, BMJ.

[23]  Maria Sorbera,et al.  Evaluation of virologic suppression rates during the COVID‐19 pandemic with outpatient interdisciplinary HIV care , 2021, Journal of the American College of Clinical Pharmacy : JACCP.

[24]  Rebecca J. Cope,et al.  Outpatient management of chronic warfarin therapy at a pharmacist-run anticoagulation clinic during the COVID-19 pandemic , 2021, Journal of Thrombosis and Thrombolysis.

[25]  Martha Stutsky,et al.  Advancing ambulatory pharmacy practice through a crisis: Objectives and strategies used in an ambulatory care action team’s response to the COVID-19 pandemic , 2021, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[26]  Derar H. Abdel-Qader,et al.  Virtual pharmacist interventions on abuse of over-the-counter medications during COVID-19 versus traditional pharmacist interventions , 2021, Journal of the American Pharmacists Association.

[27]  M. Marchese,et al.  Development of a process map for the delivery of virtual clinical pharmacy services at Odette Cancer Centre during the COVID-19 pandemic , 2021, Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners.

[28]  E. Devol,et al.  What is the ideal clinical pharmacy practice model? A satisfaction comparative study , 2021, JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY.

[29]  Phuong Dao,et al.  Outpatient clinical pharmacy practice in the face of COVID-19 at a cancer center in New York City , 2021, Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners.

[30]  Sherry‐Ann Brown,et al.  A virtual-hybrid approach to launching a cardio-oncology clinic during a pandemic , 2021, Cardio-Oncology.

[31]  L. Peikova,et al.  Opportunities of information communication technologies for providing pharmaceutical care in the COVID-19 pandemic , 2021 .

[32]  Xiao-Dong Du,et al.  Use of a Remote Oncology Pharmacy Service Platform for Patients With Cancer During the COVID-19 Pandemic: Implementation and User Acceptance Evaluation , 2021, Journal of Medical Internet Research.

[33]  C. Snoswell,et al.  The pharmacist informatician: providing an innovative model of care during the COVID-19 crisis , 2020, The International journal of pharmacy practice.

[34]  Yu Zhang,et al.  Evaluation of the role and usefulness of clinical pharmacists at the Fangcang Hospital during COVID‐19 outbreak , 2020, International journal of clinical practice.

[35]  Xiao-Dong Du,et al.  Implementation of A Remote Oncology Pharmacy Service Platform During the COVID-19 Pandemic: The Sun Yat-sen University Cancer Center Experience. , 2020, Journal of medical Internet research.

[36]  R. Madhan,et al.  Assessment of Clinical Pharmacists' Assistance for Patients With Established Cardiovascular Diseases During the COVID-19 Pandemic: Insights From Southern India , 2020, Frontiers in Cardiovascular Medicine.

[37]  Michael Khazaka,et al.  Management of human resources of a pharmacy department during the COVID-19 pandemic: Take-aways from the first wave , 2020, Research in Social and Administrative Pharmacy.

[38]  Jamie Yuen,et al.  Provision of Virtual Outpatient Care during the COVID-19 Pandemic and Beyond: Enabling Factors and Experiences from the UBC Pharmacists Clinic , 2020, Innovations in pharmacy.

[39]  A. Peláez Bejarano,et al.  Implementation of a novel home delivery service during pandemic , 2020, European journal of hospital pharmacy : science and practice.

[40]  O. Ibrahim,et al.  Role of telepharmacy in pharmacist counselling to coronavirus disease 2019 patients and medication dispensing errors , 2020, Journal of telemedicine and telecare.

[41]  Derar H. Abdel-Qader,et al.  Evaluation of Telepharmacy Services in Light of COVID-19. , 2020, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[42]  D. Goff,et al.  Global contributions of pharmacists during the COVID‐19 pandemic , 2020, Journal of the American College of Clinical Pharmacy : JACCP.

[43]  J. Razzak,et al.  Telemedicine in the United States: An Introduction for Students and Residents , 2020, Journal of medical Internet research.

[44]  Abdel-Naser Elzouki,et al.  The experience of Hamad General Hospital collaborative anticoagulation clinic in Qatar during the COVID-19 pandemic , 2020, Journal of Thrombosis and Thrombolysis.

[45]  M. Romano,et al.  Feasibility and Acceptability of Telemedicine to Substitute Outpatient Rehabilitation Services in the COVID-19 Emergency in Italy: An Observational Everyday Clinical-Life Study , 2020, Archives of Physical Medicine and Rehabilitation.

[46]  J. Moore,et al.  Integrated electronic health record facilitates a safer and more efficient rural outreach haematology service , 2020, Internal medicine journal.

[47]  M. Bouvy,et al.  Impact of the COVID-19 epidemic on the provision of pharmaceutical care in community pharmacies , 2020, Research in Social and Administrative Pharmacy.

[48]  C. Fernández-Llamazares,et al.  Survey on the situation of telepharmacy as applied to the outpatient care in hospital pharmacy departments in Spain during the COVID-19 pandemic. , 2020, Farmacia hospitalaria : organo oficial de expresion cientifica de la Sociedad Espanola de Farmacia Hospitalaria.

[49]  M. Zhong,et al.  Role of pharmacists during the COVID‐19 pandemic in China‐Shanghai experiences , 2020, Journal of the American College of Clinical Pharmacy : JACCP.

[50]  J. Poveda-Andrés,et al.  Pharmaceutical care to hospital outpatients during the COVID-19 pandemic. Telepharmacy. , 2020, Farmacia hospitalaria : organo oficial de expresion cientifica de la Sociedad Espanola de Farmacia Hospitalaria.

[51]  Rena A. Gosser,et al.  Establishing clinical pharmacist telehealth services during the COVID-19 pandemic , 2020, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[52]  H. Berlie,et al.  Ambulatory care practice in the COVID‐19 era: Redesigning clinical services and experiential learning , 2020, Journal of the American College of Clinical Pharmacy : JACCP.

[53]  Gabriel V. Fontaine,et al.  COVID-19 preparedness: Clinical pharmacy services remote staffing in a quaternary, level I trauma and comprehensive stroke center , 2020, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[54]  Si-qian Zheng,et al.  Fighting against COVID-19: Innovative strategies for clinical pharmacists , 2020, Research in Social and Administrative Pharmacy.

[55]  R. Ohannessian,et al.  Global Telemedicine Implementation and Integration Within Health Systems to Fight the COVID-19 Pandemic: A Call to Action , 2020, JMIR public health and surveillance.

[56]  C. Ung Community pharmacist in public health emergencies: Quick to action against the coronavirus 2019-nCoV outbreak , 2020, Research in Social and Administrative Pharmacy.

[57]  N. Peel,et al.  A scoping review of the use and impact of telehealth medication reviews. , 2019, Research in social & administrative pharmacy : RSAP.

[58]  Vangelis Sakkalis,et al.  PharmActa: Personalized pharmaceutical care eHealth platform for patients and pharmacists , 2019, J. Biomed. Informatics.

[59]  W. Fandino Formulating a good research question: Pearls and pitfalls , 2019, Indian journal of anaesthesia.

[60]  Begoña García Zapirain,et al.  Predictive, Personalized, Preventive and Participatory (4P) Medicine Applied to Telemedicine and eHealth in the Literature , 2019, Journal of Medical Systems.

[61]  R. Hansen,et al.  Impact of eHealth on medication adherence among patients with asthma: A systematic review and meta-analysis. , 2019, Respiratory medicine.

[62]  T. Dhippayom,et al.  The Effects of Telemedicine on Asthma Control and Patients' Quality of Life in Adults: A Systematic Review and Meta-analysis. , 2019, The journal of allergy and clinical immunology. In practice.

[63]  I. Hegger,et al.  A logic model for pharmaceutical care , 2018, Journal of health services research & policy.

[64]  S. Kane-Gill,et al.  Impact of clinical pharmacist services delivered via telemedicine in the outpatient or ambulatory care setting: A systematic review , 2017, Research in social & administrative pharmacy : RSAP.

[65]  Dave L Dixon,et al.  Pharmacists providing care in the outpatient setting through telemedicine models: a narrative review , 2017, Pharmacy practice.

[66]  F. Federico,et al.  The impact of health information technology on patient safety , 2017, Saudi medical journal.

[67]  Nathorn Chaiyakunapruk,et al.  Comparative effectiveness of telemedicine strategies on type 2 diabetes management: A systematic review and network meta-analysis , 2017, Scientific Reports.

[68]  Peter M. A. Sloot,et al.  eHealth in the future of medications management: personalisation, monitoring and adherence , 2017, BMC Medicine.

[69]  T. Bertsche,et al.  Verwendung von Routinedaten der gesetzlichen Krankenkasse in einer Pilotstudie zur Evaluation pharmazeutischer Interventionen im Krankenhaus , 2017 .

[70]  J. Glazier,et al.  Inhibition of placental mTOR signaling provides a link between placental malaria and reduced birthweight , 2017, BMC Medicine.

[71]  T. Bertsche,et al.  [Utilising statutory health insurance data to evaluate pharmaceutical interventions in secondary care - a pilot study]. , 2017, Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen.

[72]  L. Nissen,et al.  Telepharmacy: a pharmacist’s perspective on the clinical benefits and challenges , 2016, Integrated pharmacy research & practice.

[73]  R. Ohannessian,et al.  Telemedicine: Potential applications in epidemic situations , 2015, European Research in Telemedicine / La Recherche Européenne en Télémédecine.

[74]  Harminder Singh,et al.  Understanding the effect of e-learning on individual performance: The role of digital literacy , 2015, Comput. Educ..

[75]  L. Luxon Infrastructure – the key to healthcare improvement , 2015, Future Hospital Journal.

[76]  L. Emmerton,et al.  The introduction of the national e‐health record into Australian community pharmacy practice: pharmacists’ perceptions , 2013, The International journal of pharmacy practice.

[77]  C. V. Woerkum,et al.  Cost Effectiveness of Medication Adherence-Enhancing Interventions: A Systematic Review of Trial-Based Economic Evaluations , 2013, PharmacoEconomics.

[78]  L. Bero,et al.  The effect of pharmacist-provided non-dispensing services on patient outcomes, health service utilisation and costs in low- and middle-income countries. , 2013, The Cochrane database of systematic reviews.

[79]  Marissa Salvo,et al.  Glycemic Control and Preventive Care Measures of Indigent Diabetes Patients Within a Pharmacist-Managed Insulin Titration Program vs Standard Care , 2012, The Annals of pharmacotherapy.

[80]  Boon Peng Lim,et al.  The evolving role of the community pharmacist in chronic disease management - a literature review. , 2010, Annals of the Academy of Medicine, Singapore.

[81]  Ivo Abraham,et al.  Economic effects of pharmacists on health outcomes in the United States: A systematic review. , 2010, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[82]  Lisa Bero,et al.  Effect of outpatient pharmacists' non-dispensing roles on patient outcomes and prescribing patterns. , 2010, The Cochrane database of systematic reviews.

[83]  Richard J. Holden,et al.  The Technology Acceptance Model: Its past and its future in health care , 2010, J. Biomed. Informatics.

[84]  W. J. Elliott,et al.  Effectiveness of Home Blood Pressure Monitoring, Web Communication, and Pharmacist Care on Hypertension Control: A Randomized Controlled Trial , 2009 .

[85]  J. Ralston,et al.  Effectiveness of home blood pressure monitoring, Web communication, and pharmacist care on hypertension control: a randomized controlled trial. , 2008, JAMA.

[86]  Gregory M. Peterson,et al.  Telepharmacy—Enabling Technology to Provide Quality Pharmacy Services in Rural and Remote Communities , 2006 .

[87]  Jane Hendy,et al.  Challenges to implementing the national programme for information technology (NPfIT): a qualitative study , 2005, BMJ : British Medical Journal.

[88]  M. J. Martín-Calero,et al.  Pharmaceutical care: past, present and future. , 2004, Current pharmaceutical design.

[89]  D. Witt,et al.  A Retrospective Evaluation of the Management of Excessive Anticoagulation in an Established Clinical Pharmacy Anticoagulation Service Compared to Traditional Care , 2003, Journal of Thrombosis and Thrombolysis.

[90]  Mary B. Myers,et al.  Telemedicine: An Emerging Health Care Technology , 2003, The health care manager.

[91]  A. Bynum,et al.  The effect of telepharmacy counseling on metered-dose inhaler technique among adolescents with asthma in rural Arkansas. , 2001, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[92]  C. Hepler,et al.  Opportunities and responsibilities in pharmaceutical care. , 1990, American journal of hospital pharmacy.