Available via license: CC BY 4.0
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Citation: Ahmed, N.J.; Almalki, Z.S.;
Alsawadi, A.H.; Alturki, A.A.;
Bakarman, A.H.; Almuaddi, A.M.;
Alshahrani, S.M.; Alanazi, M.B.;
Alshehri, A.M.; Albassam, A.A.; et al.
Knowledge, Perceptions, and
Readiness of Telepharmacy among
Hospital Pharmacists in Saudi Arabia.
Healthcare 2023,11, 1087. https://
doi.org/10.3390/healthcare11081087
Academic Editor: Francesco Sessa
Received: 5 March 2023
Revised: 6 April 2023
Accepted: 9 April 2023
Published: 11 April 2023
Copyright: © 2023 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
healthcare
Article
Knowledge, Perceptions, and Readiness of Telepharmacy
among Hospital Pharmacists in Saudi Arabia
Nehad J. Ahmed 1, * , Ziyad S. Almalki 1, Asmaa H. Alsawadi 2, Abdulmohsen A. Alturki 1,
Abdulaziz H. Bakarman 2, Alwaleed M. Almuaddi 1, Saeed M. Alshahrani 1, Meshari B. Alanazi 1,
Ahmed M. Alshehri 1, Ahmed A. Albassam 1, Abdullah K. Alahmari 1, Ghada M. Alem 1, Saad A. Aldosari 1
and Ahmad A. Alamer 1
1Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam bin Abdulaziz University,
Al Kharj 11942, Saudi Arabia
2Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, Almaarefa University,
Riyadh 13713, Saudi Arabia
*Correspondence: n.ahmed@psau.edu.sa; Tel.: +966-115-886-054
Abstract:
Telepharmacy is a technology-based service that provides promoted services such as
counseling, medication administration and compounding, drug therapy monitoring, and prescription
review. It is unclear whether hospital pharmacists possess the necessary knowledge, attitudes,
and willingness to practice telepharmacy. The current study sought to investigate Saudi Arabian
hospital pharmacists’ understanding, attitudes, and level of preparedness for telepharmacy services.
A total of 411 pharmacists responded to the survey. Only 43.33% of the respondents agreed that
telepharmacy is available in Saudi Arabia and 36.67% of the respondents agreed that patients in
rural areas can have more medication access and information via telepharmacy. Only 29.33% of
pharmacists agreed that telepharmacy improves patient medication adherence, and about 34.00% of
the pharmacists agreed that telepharmacy saves patients money and time by eliminating the need for
them to travel to healthcare facilities. This research found that hospital pharmacists were unsure of
their level of knowledge, their attitude toward telepharmacy, and their willingness to incorporate
it into their future pharmacy practices. To ensure that tomorrow’s pharmacists have the skills they
need to provide telepharmacy services, telepharmacy practice models must be incorporated into the
educational programs that prepare them.
Keywords: hospital pharmacists; knowledge; perception; readiness; telepharmacy
1. Introduction
Using information and communication technology in pharmacy and healthcare opens
up new ways to provide health services and helps solve the problem of a lack of health
professionals [
1
]. Electronic health records and other new technologies, such as electronic
health information systems, make it easier for pharmacists to find information about an
exam or a drug therapy that was prescribed. By using these technologies, pharmacists
can improve how drugs are used and also get the word out about telepharmaceutical
services [2].
The National Association of Boards of Pharmacy defines it as “the provision of phar-
macological treatment to patients at a distance using information and communication
technology” [
3
]. Telepharmacy is a technology-based service that offers services such as
prescription evaluation, medicine administration and compounding, drug therapy mon-
itoring, and counseling [
4
–
6
]. Telepharmacy services include reviewing pharmaceutical
orders, giving out drugs, counseling and evaluating patients, monitoring therapeutic drug
use, and managing medication treatment [7].
Telepharmacy lets patients obtain their prescriptions and other pharmaceutical care
services without having to go to a pharmacy [
3
,
4
]. It was found to reduce travel costs and
Healthcare 2023,11, 1087. https://doi.org/10.3390/healthcare11081087 https://www.mdpi.com/journal/healthcare
Healthcare 2023,11, 1087 2 of 11
save time, both of which are important barriers for patients in rural and faraway areas
who need healthcare services, especially the disabled and elderly [
4
,
8
,
9
]. Telepharmacy
also helps patients stay on their medicines by making them happier and more confident in
the services they receive [
10
,
11
]. In addition, it has made pharmacists’ clinical roles more
effective by giving them enough time for drug counseling in a more private setting [
12
,
13
].
The social distance between patients and healthcare providers has been enabled in
many countries through the facilitation of remote pharmaceutical care services such as In-
ternet services, virtual medical consultations, e-prescriptions, and home drug delivery [
14
].
With its origins in addressing healthcare access issues in rural regions, telepharmacy reaches
its maximum use during global health crises [
6
]. Telepharmacy was quickly recognized
as a tool capable of overcoming many of the pandemic’s challenges. The introduction of
COVID-19 has accelerated the changes that would make telepharmacy a viable option. As
healthcare providers and patients recognize the benefits of telepharmacy, there is a chance
that it will continue even after the pandemic is over [
15
]. Ibrahim et al. reported that
pharmacies with remote pharmacy services could help more patients with COVID-19 and
confirm COVID-19 diagnosis more quickly than pharmacies without remote pharmacy ser-
vices. They also reported that pharmacies with remote services were less likely than other
pharmacies to make mistakes during medication dispensing [
16
]. Casey et al. found that
the number of mistakes made when giving out medications decreased after a telepharmacy
service was put in place [3].
There are several studies about the knowledge, perceptions, and readiness of phar-
macists in community pharmacies in Saudi Arabia about telepharmacy. There are also
studies about the knowledge, perception, and willingness of the public to use telepharmacy
services. Nonetheless, there are no studies on the knowledge, perceptions, and readiness
of hospital pharmacists about telepharmacy in Saudi Arabia, except in one conference
abstract [
17
]. So, the present study included pharmacists who are working in hospital
pharmacies. Therefore, the goal of this study was to find out what Saudi Arabian hospital
pharmacists know, how they feel about telepharmacy services, and how ready they are to
use them.
2. Materials and Methods
Between March and May 2020, a cross-sectional study was conducted among Saudi
Arabian hospital pharmacists to assess their knowledge, perceptions, and readiness for tele-
pharmacy. Pharmacists who worked in Saudi Arabian hospital pharmacies were included
in the study. Pharmacists who worked in other settings such as community pharmacies
and pharmaceutical companies were not included in the study. The subjects’ involvement
was entirely voluntary, and there was no monetary incentive.
An online survey was used to obtain data from the participants, and it was based on a
validated questionnaire used by a previous study [
18
]. The questionnaire was provided in
English. After taking into account their experience and knowledge of the study subject,
four pharmacy academicians reviewed the content validity of the questionnaire. After that,
we sent the questionnaire to a few pharmacists as a pilot test to weed out any unnecessary
or inadequate queries (the questionnaire was attached as a supplementary file).
The questionnaire was created using Google Forms as an online form. Data were col-
lected on respondent demographics, employment statistics, hospital pharmacist knowledge
about telepharmacy, pharmacist telepharmacy attitudes, and pharmacist telepharmacy
preparedness. The online survey was sent to the pharmacists’ emails, and it was sent to
other pharmacists using WhatsApp. After the pharmacists sent their responses, we checked
the surveys to ensure that the surveys were filled out completely.
The sample size was calculated using the RAO sample size calculator, and using
a margin error of 5%, confidence level of 95%, and response distribution of 50%. The
minimum recommended size of our survey was 377 pharmacists.
The data were gathered using an Excel spreadsheet, and the descriptive results were
presented in the form of numbers and percentages. After that, the Statistical Package for
Healthcare 2023,11, 1087 3 of 11
Social Science (SPSS) was used for the data analysis. Differences in pharmacists’ knowledge,
perception, and readiness scores in relation to years of experience were assessed using
an independent samples t-test. The level of significance was set at p< 0.05. The study
was approved by the Research Ethics Committee/Health and Science Disciplines at Prince
Sattam Bin Abdulaziz University with an approval number REC-HSD-134-2022.
3. Results
The survey was sent to five hundred pharmacists. A total of four hundred eleven
individuals responded to the survey (the response rate was 82.2%). Males made up 54.01%
of the respondents, with 71.29% of them being between the ages of 30 and 39 years, and
the age of 24.33% of them was between 20 and 29 years. Most of the respondents had
a bachelor’s degree in pharmacy (46.71%) or a PharmD degree (27.01%), and 20.44% of
them had a master’s degree. Most of the responders (87.10%) received their most recent
pharmacy degree or training in Saudi Arabia, and 5.11% of them received a pharmacy
degree or training in the United States (Table 1).
Table 1. Demographic data of the respondents (n = 411).
Variable Category Number Percentage
Gender Male 222 54.01
Female 189 45.99
Age 20–29 100 24.33
30–39 293 71.29
40–49 16 3.89
More than 49 2 0.49
Education level Bachelor’s degree 192 46.71
Pharm.D. 111 27.01
Master’s degree 84 20.44
Doctorate degree
(Ph.D.) 12 2.92
Other 12 2.92
In which country
have you earned your
latest pharmacy
degree or training?
Saudi Arabia 358 87.10
UK 9 2.19
USA 21 5.11
Australia 6 1.46
Malaysia 3 0.73
Egypt 5 1.22
India 3 0.73
Pakistan 2 0.49
Other 4 0.97
Nationality Saudi Arabia 400 97.32
Others * 11 2.68
* Others: Pharmacists who work in Saudi Arabia, but are not Saudis (For example, Pakistani, Indian, Jordanian,
and Egyptian pharmacists).
Approximately 59.37% of pharmacists were employed in the Riyadh region, 9.49% in
the Al-Qassim region, and 7.30% in the Makkah region (Figure 1).
Most of the pharmacists (62.53%) worked in urban areas, and 51.34% of them had less
than five years of experience in hospital pharmacies. About 48.66% of the pharmacists
were staff pharmacists, about 28.96% of them worked in an outpatient pharmacy, and
about 44.28% of them worked in a primary healthcare institution. Most of the respondents
had never provided pharmaceutical services via telepharmacy before (63.50%). More
than half of the respondents (54.01%) stated that social media was their primary source
of information, while 33.09% said that the Ministry of Health website was their primary
source of information (Table 2).
Healthcare 2023,11, 1087 4 of 11
Healthcare 2023, 11, x FOR PEER REVIEW 4 of 12
Approximately 59.37% of pharmacists were employed in the Riyadh region, 9.49% in
the Al-Qassim region, and 7.30% in the Makkah region (Figure 1).
Figure 1. The regions where pharmacists work.
Most of the pharmacists (62.53%) worked in urban areas, and 51.34% of them had
less than ve years of experience in hospital pharmacies. About 48.66% of the pharmacists
were sta pharmacists, about 28.96% of them worked in an outpatient pharmacy, and
about 44.28% of them worked in a primary healthcare institution. Most of the respondents
had never provided pharmaceutical services via telepharmacy before (63.50%). More than
half of the respondents (54.01%) stated that social media was their primary source of
information, while 33.09% said that the Ministry of Health website was their primary
source of information (Table 2).
Table 2. Employment data of the respondents (n = 411).
Variable
Category
Number
Percentage
What is your area of work?
Rural
154
37.47
Urban
257
62.53
Years of experience in pharmacy
Less than 5maomao5–
10maomao11–
15maomaoMore than 15
211maom
ao162mao
mao15ma
omao23
51.34maomao
39.41maomao
3.65maomao5.
60
What is your job position at your
hospital pharmacy?
Staff
pharmacistmaomaoClinical
pharmacistmaomaoPharm
acy
supervisormaomaoPharma
cy managermaomaoOther
200maom
ao73mao
mao24ma
omao72m
aomao42
48.66maomao
17.76maomao
5.84maomao1
7.52maomao1
0.22
What is your hospital pharmacy
setting?
Out-patient
pharmacymaomaoIn-
patient
pharmacymaomaoClinical
pharmacymaomaoOther
119maom
ao116mao
mao72ma
omao104
28.96maomao
28.22maomao
17.52maomao
25.30
What is the level of your healthcare
institution?
PrimarymaomaoSecondary
maomaoTertiary
182maom
ao91mao
mao138
44.28maomao
22.14maomao
33.58
Have you previously provided
pharmaceutical services through
telepharmacy?
YesmaomaoNo
150maom
ao261
36.50maomao
63.50
244
39 30 24 20 12 9765555
0
50
100
150
200
250
300
Figure 1. The regions where pharmacists work.
Table 2. Employment data of the respondents (n = 411).
Variable Category Number Percentage
What is your area of work? Rural 154 37.47
Urban 257 62.53
Years of experience in pharmacy
Less than 5
5–10
11–15
More than 15
211
162
15
23
51.34
39.41
3.65
5.60
What is your job position at your
hospital pharmacy?
Staff pharmacist
Clinical pharmacist
Pharmacy supervisor
Pharmacy manager
Other
200
73
24
72
42
48.66
17.76
5.84
17.52
10.22
What is your hospital
pharmacy setting?
Out-patient pharmacy
In-patient pharmacy
Clinical pharmacy
Other
119
116
72
104
28.96
28.22
17.52
25.30
What is the level of your
healthcare institution?
Primary
Secondary
Tertiary
182
91
138
44.28
22.14
33.58
Have you previously provided
pharmaceutical services
through telepharmacy?
Yes
No
150
261
36.50
63.50
Source of information
Local and
international channels
120 29.20
Social media 222 54.01
WHO website and
social pages 124 30.17
Scientific journals 104 25.30
Ministry of Health
website 136 33.09
Colleagues 119 28.95
Others 135 32.85
Only 43.33% of the respondents agreed that telepharmacy is available in Saudi Arabia,
44.00% of them agreed that telepharmacy played a significant role during the global
COVID-19 outbreak, 38.00% of the pharmacists agreed that telepharmacy provides better
Healthcare 2023,11, 1087 5 of 11
counseling in terms of privacy and the length of the session, and 38.67% of them agreed
that telepharmacy solves the waiting time problem in most general hospitals.
About 36.67% of the hospital pharmacists agreed that telepharmacy is involved in
adverse drug reaction monitoring and reporting, 36.67% of the respondents agreed that
patients in rural areas can have more medication access and information via telepharmacy,
and 39.33% of them agreed that telepharmacy services can extend hospital pharmacy
services outside office hours that do not offer round-the-clock pharmacy services (Table 3).
Table 3. Telepharmacy knowledge among pharmacists (n = 150).
Item Response Number Percentage
Telepharmacy is available in Saudi Arabia.
Yes 65 43.33
No 13 8.67
Don’t know 72 48.00
Information communication technology (ICT)
knowledge is important for pharmacists in
how to conduct telepharmacy.
Yes 67 44.67
No 15 10.00
Don’t know 68 45.33
Telepharmacy played a big role during the
COVID-19 outbreak around the world.
Yes 66 44.00
No 15 10.00
Don’t know 69 46.00
Telepharmacy does require a strong Internet
connection or high-performance technology.
Yes 61 40.67
No 17 11.33
Don’t know 72 48.00
Telepharmacy provides better counseling in
terms of privacy and length of the session.
Yes
No
Don’t know
57
16
77
38.00
10.67
51.33
Telepharmacy solves the waiting time
problem in most general hospitals.
Yes
No
Don’t know
58
20
72
38.67
13.33
48.00
Telepharmacy is also involved in adverse
drug reaction monitoring and reporting.
Yes
No
Don’t know
55
20
75
36.67
13.33
50.00
Telepharmacy is conducted by drug
information services during office hours and
by emergency departments after office hours.
Yes
No
Don’t know
55
18
77
36.67
12.00
51.33
Patients from rural areas can have more
medication access and information
via telepharmacy.
Yes
No
Don’t know
55
21
74
36.67
14.00
49.33
Telepharmacy services can extend hospital
pharmacy services outside office hours that do
not offer round-the-clock pharmacy services.
Yes
No
Don’t know
59
17
74
39.33
11.33
49.33
Only 29.33% of hospital pharmacists agreed that telepharmacy improves patient med-
ication adherence, 36.66% agreed that it improves patient access to medications in rural
areas, and only 26.66% of them agreed that telepharmacy has a higher error rate for medica-
tion dispensing and filling compared to the traditional pharmacy. Furthermore, 34.00% of
them said that telepharmacy increases the pharmacist’s workload and commitment, about
34.00% of the pharmacists agreed that telepharmacy saves patients money and time by
eliminating the need for them to travel to healthcare facilities, and about 32.00% of them
agreed that they are willing to share their personal information on the online database
when using telepharmacy services.
About 33.33% of hospital pharmacists said that telepharmacy minimizes the cost to
establish a pharmaceutical business in comparison to a regular pharmacy. About 33.33% of
the hospital pharmacists agreed that patient consultation via telepharmacy is effective, and
about 34.67% of them agreed that therapeutic drug monitoring via telepharmacy in rural
Healthcare 2023,11, 1087 6 of 11
areas is easily completed. Furthermore, 36.67% of pharmacists said that pharmacy schools
should incorporate computer sciences and telepharmacy education programs to help with
future telepharmacy use, and 33.33% of them agreed that telepharmacy helps to reduce
pharmacist shortages (Table 4).
Table 4. Telepharmacy perceptions among pharmacists (n = 150).
Items Strongly
Disagree Disagree Unsure Agree Strongly
Agree
Telepharmacy improves patient’s
adherence to the medication.
9
(6.00)
8
(5.33)
89
(59.33)
35
(23.33)
9
(6.00)
Telepharmacy has a higher error rate
for medication dispensing and filling
compared to traditional pharmacy.
5
(3.33)
14
(9.33)
91
(60.67)
32
(21.33)
8
(5.33)
Telepharmacy enhances patient’s
access to medications in rural areas.
4
(2.67)
7
(4.67)
84
(56.00)
44
(29.33)
11
(7.33)
Telepharmacy provides a complete
privacy setting during the
consultation period.
3
(2.00)
10
(6.67)
86
(57.33)
40
(26.67)
11
(7.33)
Telepharmacy increases pharmacist’s
workload and commitment.
3
(2.00)
9
(6.00)
87
(58.00)
37
(24.67)
14
(9.33)
Telepharmacy helps patients save
their money and travel time to reach
the healthcare facilities.
4
(2.67)
6
(4.00)
89
(59.33)
35
(23.33)
16
(10.67)
I am willing to share my personal
information on the online database
when using telepharmacy services.
5
(3.33)
11
(7.33)
86
(57.33)
37
(24.67)
11
(7.33)
Telepharmacy minimizes the cost to
establish a pharmaceutical business
in comparison to the
regular pharmacy.
5
(3.33)
9
(6.00)
86
(57.33)
42
(28.00)
8
(5.33)
Patient consultation via telepharmacy
is effective.
3
(2.00)
10
(6.67)
87
(58.00)
41
(27.33)
9
(6.00)
Pharmacy schools should provide
education programs on IT and
telepharmacy to assist in the future
utilization of telepharmacy.
4
(2.67)
7
(4.66)
84
(56.00)
40
(26.67)
15
(10.00)
Therapeutic drug monitoring via
telepharmacy in rural areas is
easily monitored.
4
(2.67)
11
(7.33)
83
(55.33)
40
(26.67)
12
(8.00)
Security is a greater concern in a
remote site telepharmacy than in a
traditional community pharmacy.
4
(2.67)
7
(4.66)
81
(54.00)
42
(28.00)
16
(10.67)
Telepharmacy helps to minimize the
shortage of pharmacists.
4
(2.67)
8
(5.33)
88
(58.67)
38
(25.33)
12
(8.00)
About 27.74% of the hospital pharmacists agreed that they are ready to work on
telepharmacy projects in rural areas, even without an incentive, and 34.55% of them said
that they are ready to work after office hours if needed. About 36.5% of pharmacists stated
they are ready to provide pharmaceutical advice via two-way video consultation, such as
phone calls, text messaging, or voice conversations using mobile devices. More than 39%
of the pharmacists said that they are ready to teach patients how to use their drug delivery
device through video consultation, and more than 37% of them agreed that they are ready
to undergo training in ethics and legal issues related to telepharmacy.
Healthcare 2023,11, 1087 7 of 11
About 35.28% of pharmacists said that they are prepared to tackle telepharmacy imple-
mentation in all clinical settings. Furthermore, about 37.96% of pharmacists stated that they
are ready to utilize telepharmacy to increase patient safety and prevent prescription errors,
and 39.17% of them said that they are ready to use telepharmacy to conduct medication
reconciliation. More than 36% of the pharmacists agreed that they are ready to perform
remote prescription-checking using an automated medication dispensing cabinet, and
36.98% of them said that they are ready to use applications and the Internet to receive refill
orders and transfer prescriptions (see Table 5).
Table 5. Telepharmacy readiness among pharmacists (n = 411).
Items Strongly Disagree Disagree Unsure Agree Strongly Agree
I am ready to work on telepharmacy projects in
rural areas, even without an incentive.
19
(4.62)
37
(9.00)
241
(58.64)
87
(21.17)
27
(6.57)
I am ready to work after office hours if needed. 15
(3.65)
20
(4.87)
234
(56.93)
108
(26.28)
34
(8.27)
I am ready to conduct drug counseling via
two-way video consultation. *
10
(2.43)
20
(4.87)
231
(56.20)
120
(29.20)
30
(7.30)
I am ready to teach patients how to use their
drug delivery devices through
video consultation.
8
(1.95)
25
(6.08)
217
(52.80)
125
(30.41)
36
(8.76)
I am ready to undergo training in ethics and
legal issues related to telepharmacy.
8
(1.95)
18
(4.38)
231
(56.20)
113
(27.49)
41
(9.98)
I am ready to face the implementation of
telepharmacy in all healthcare settings.
8
(1.95)
22
(5.35)
236
(57.42)
106
(25.79)
39
(9.49)
I am ready to conduct a home medication review
(HMR) through telepharmacy.
8
(1.95)
22
(5.35)
239
(58.15)
112
(27.25)
30
(7.30)
I am ready to reduce the risk of medication
errors among patients through telepharmacy.
10
(2.43)
17
(4.14)
228
(55.47)
126
(30.66)
30
(7.30)
I am ready to carry the increment of workload
when conducting telepharmacy.
10
(2.43)
27
(6.57)
223
(54.25)
109
(26.52)
42
(10.22)
I am ready to conduct medication reconciliation
via telepharmacy services.
9
(2.19)
17
(4.14)
224
(54.50)
119
(28.95)
42
(10.22)
I am ready to perform remote
prescription-checking using an automated
medication dispensing cabinet.
8
(1.95)
21
(5.11)
231
(56.20)
115
(27.98)
36
(8.76)
I am ready to use applications and the Internet
to receive refill orders and transfer prescriptions.
12
(2.92)
16
(3.89)
231
(56.20)
113
(27.49)
39
(9.49)
* Two-way video consultation such as telephone calls, text messages, or voice calls through mobile applications.
The differences in pharmacists’ knowledge, perception, and readiness scores in relation
to years of experience are shown in Table 6. Regarding the knowledge, the correct answers
were given 1 and the incorrect answers were given 0, and after that we calculated the
average knowledge score. Regarding perceptions and readiness, strongly agree and agree
were given 1; neutral, disagree, and strongly disagree were given 0; after that, we calculated
the average perceptions and readiness scores. The average knowledge score, perceptions
score, and readiness score were higher in pharmacists who had less than 5 years compared
with pharmacists who had 5 or more years of experience (pvalue less than 0.05).
Healthcare 2023,11, 1087 8 of 11
Table 6.
Differences in pharmacists’ knowledge, perception, and readiness scores in relation to years
of experience.
Years of Experience Average Knowledge Score pValue
Less than 5 0.42 0.02
More than 5 years 0.38
Years of experience The average score for perceptions pvalue
Less than 5
More than 5 years
0.39
0.28 0.003
Years of experience The average score for readiness pvalue
Less than 5
More than 5 years
0.41
0.31 0.008
4. Discussion
In this study, hospital pharmacists in Saudi Arabia were asked about their knowledge,
perceptions, and preparation for telepharmacy. Less than half of the pharmacists said that
telepharmacy is available in Saudi Arabia. In general, there was uncertainty and variation
in the response of the hospital pharmacists regarding their knowledge, which could be
explained by the fact that it has not yet been fully developed and made widely available.
Similarly, Elnaem et al. noted in their study that there was some uncertainty in the responses
of future pharmacists in Malaysia [
18
]. Omran et al. reported that approximately 40% of
Egyptian pharmacists were unfamiliar with the term telepharmacy [
19
]. Moreover, Tegegne
et al. reported that only 32.4% of the pharmacy students in northwest Ethiopia had good
knowledge of telepharmacy [20].
About 44% of pharmacists reported that telepharmacy played a big role during the
COVID-19 outbreak around the world. Telepharmacy could overcome many of the chal-
lenges presented by the COVID-19 pandemic while still providing quality patient care [
15
].
Elnaem et al. stated that 93.8% of future Malaysian pharmacists agreed that telepharmacy
played a big role during the COVID-19 outbreak around the world [18]. Unni et al. stated
that the introduction of COVID-19 has hastened the changes required to make telephar-
macy a viable option. They also stated that telepharmacy may continue even after the
pandemic is over, as healthcare providers and patients recognize its benefits [
15
]. Accord-
ing to Ibrahim et al. pharmacies with remote pharmacy services could assist COVID-19
patients faster than pharmacies without remote pharmacy services [
16
]. Telepharmacy is a
remote pharmaceutical care procedure. It has been used worldwide during the COVID-19
pandemic, with the aim of preserving the health of patients and professionals [
21
]. Dat
et al. reported that about 87% of pharmacists have used telepharmacy in their pharmacy
practice in response to the COVID-19 pandemic in Ho Chi Minh City, Vietnam. They also
reported that the provision of medical information and remote medication counseling was
an urgent need in the context of limited travel because of the COVID-19 pandemic [22].
Pharmacists are medical experts in charge of making sure that patients have access
to the medications they require. Pharmacists must develop methods for the purchase,
storage, and distribution of medications in order to accomplish this. This is in line with
the pharmacist’s responsibility for addressing sufficient access to medications, one of the
social determinants of health. When pharmacists provide care to a community that is
underprivileged, rural, or remote, this duty becomes vital [
23
]. More than one-third of phar-
macists in the current study said that telepharmacy can provide more drug availability and
information to patients in remote places, and about half were uncertain. Ibrahim et al. [
16
]
reported that many healthcare practitioners use telepharmacy services to improve patients’
access to pharmaceutical care. Furthermore, the Elnaem et al. study and the Poudel and
Nissen study [
8
,
18
] showed that telepharmacy plays a significant role in improving drug
access for patients in rural areas. Pathak et al. stated that telepharmacies are a suitable
solution for expanding medication access and that using a telepharmacy would not have a
Healthcare 2023,11, 1087 9 of 11
negative impact on medication quality [
24
]. Omboni et al. reported that telepharmacy can
provide access to healthcare services in remote communities [25].
When feasible, telepharmacy helps patients avoid waiting in a clinic with other sick
patients, save time traveling, avoid work loss, and get themselves and their families healthy.
Telepharmacy saves patients money and time by eliminating the need for them to visit
healthcare facilities, according to 34.00% of pharmacists in the current study. Previous
research has demonstrated that telepharmacy reduces travel costs and saves time, which
are considered a major barrier to patients in rural and distant settings, particularly the
disabled and elderly, receiving healthcare services [
4
,
9
]. More than 91% of pharmacists in
Alanazi et al.’s study considered that employing a telepharmacy system may save them
time and money [
17
]. The beneficial effect of telepharmacy in conserving patients’ resources
was evaluated positively by study participants, with 91 percent agreement [
18
], according
to Elnaem et al.
It is more difficult for people to fill prescriptions and obtain access to other essential
services in rural regions due to a lack of pharmacies. Rural areas with a shortage of
pharmacists experienced a reduction in turnaround time for clinical pharmacy services and
an increase in medication errors linked to pharmacies. According to the current survey,
about 33.33% of pharmacists believed that telepharmacy helps to minimize pharmacist
shortages. Telepharmacy has already been shown to help with the provision and delivery of
healthcare services for patients in rural locations or in situations when access to healthcare
or pharmaceutical services is problematic for any reason [
26
–
28
]. In rural areas, where there
is a shortage of pharmacists and clinicians, telepharmacy and telehealth clinical pharmacy
services can fill the gap. Telepharmacy is a solution to the shortage of pharmacy employees,
according to Baldoni et al. in which pharmaceutical services are provided remotely [
29
].
Furthermore, 75% of respondents in Elnaem et al.’s study agreed that telepharmacy may
help alleviate the current pharmacist shortage [
18
]. Poudel and Nissen reported that
telepharmacy addresses pharmacist shortages in rural areas and improves patient access to
pharmaceuticals and pharmacy services [8].
The current study showed lower telepharmacy readiness among participants. Elnaem
et al. reported that about 67% of the senior pharmacy students in a Malaysian public
pharmacy school had high knowledge, and 68% of them showed high readiness levels.
They also reported that factors such as a lack of incentive and an excessive workload
were linked to participants’ telepharmacy preparedness [
18
]. Payment and reimbursement
issues, as well as a lack of access to information technology infrastructure, were among
the most important roadblocks, according to Ameri et al. [
30
]. According to Omran et al.
the main barriers to telepharmacy practice included a lack of professional training, ethical
concerns, and a formal practice framework [
19
]. Dat et al. reported that about 87.2% of
the pharmacists in their study were ready to use telepharmacy [
22
]. Pharmacy colleges
should incorporate telepharmacy practice models into their curricula in order to better
prepare future pharmacists to provide telepharmacy services. Additionally, pharmacists’
knowledge and preparedness to utilize telepharmacy can be improved through the delivery
of lectures, workshops, and conference attendance.
The present study showed that the average knowledge score, perceptions score, and
readiness score were higher in pharmacists who had less than 5 years compared with
pharmacists who had 5 or more years of experience. According to Fortnez et al.’s study,
only younger pharmacist participants had higher levels of interest in and favorable views
toward using telemedicine resources [
31
]. Ng and Sze reported that community pharmacists
who are younger and have fewer years of experience in the workforce are more likely to
have a favorable outlook toward the adoption of telepharmacy [
32
]. Telepharmacy services
would appeal mainly to younger pharmacists, according to Ilki et al. [
33
]. Continuing
professional education is a relevant venue to increase knowledge and promote a positive
attitude towards telepharmacy, especially for older pharmacists.
The first limitation of the study was that it was based on an online survey, which could
have resulted in selection bias. The study’s second limitation was that we have the contact
Healthcare 2023,11, 1087 10 of 11
information of several pharmacists who worked in several cities in Saudi Arabia, but we
could not send emails and messages to all of the pharmacists who work in Saudi Arabia.
Therefore, the present study included a small number of pharmacists, making the findings’
generalizability questionable. Further studies with larger sample sizes are needed to obtain
more accurate or representative results.
5. Conclusions
From the results of this research, it is clear that there was uncertainty among hospital
pharmacists regarding their level of telepharmacy knowledge, their attitude toward the
practice, or their level of preparedness to incorporate it into their future pharmacy operations.
Supplementary Materials:
The following supporting information can be downloaded at: https:
//www.mdpi.com/article/10.3390/healthcare11081087/s1, File S1: the questionnaire.
Author Contributions:
Conceptualization, methodology, and data analysis, N.J.A., Z.S.A., A.H.A., A.A.A.
(Abdulmohsen A. Alturki), A.A.A. (Ahmad A. Alamer), A.H.B.,
A.M.A. (Alwaleed M. Almuaddi)
, S.M.A.,
M.B.A., A.K.A. and G.M.A.; writing—original draft preparation, N.J.A.; writing—review and editing,
Z.S.A. and A.M.A. (Ahmed M. Alshehri); supervision, project administration, and funding acquisition,
S.A.A., A.A.A. (Ahmed A. Albassam), Z.S.A. and N.J.A. All authors have read and agreed to the published
version of the manuscript.
Funding: This study is supported via funding from Prince Sattam bin Abdulaziz University project
number (PSAU/2023/R/1444).
Institutional Review Board Statement:
The study was approved by the Research Ethics Commit-
tee/Health and Science Disciplines at Prince Sattam bin Abdulaziz University with the approval
number REC-HSD-134-2022.
Informed Consent Statement: Not applicable.
Data Availability Statement: Data available on request due to restrictions.
Acknowledgments: This study is supported via funding from Prince Sattam bin Abdulaziz Univer-
sity project number (PSAU/2023/R/1444).
Conflicts of Interest: The authors declare no conflict of interest.
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