Remote patient monitoring outpatient telepharmacy services: A systematic review

OBJECTIVE: The aim of this review was to describe the existing evidence internationally regarding remote patient monitoring (RPM) outpatient telepharmacy service models, with a secondary focus on patient and service outcomes, enablers, and barriers. METHODS: This systematic review was conducted using PubMed, CINAHL, and Embase. Key search terms included pharmacy, telepharmacy, and outpatient; data extraction and narrative analysis were then performed, along with quality assessment and characterisation of the level of evidence provided by each paper. Original research articles were included if they described the service model for an RPM telepharmacy intervention for adult outpatients. Pharmacy staff delivering the service had to be a pharmacist or pharmacy technician; pharmacy student telepharmacy models were not included. Models that did not have a clinical consult component, such as health professional to health professional interactions or medication delivery were excluded. RESULTS: There were 33 articles included in this review, and the service models included scheduled phone consultations for symptom monitoring, interactive voice response (IVR) systems, mobile applications, short message service (SMS) and web communications. The studies found positive patient outcomes, including improved blood pressure control, improved blood glucose and/or HbA1c levels, reduced number of individuals at high-risk of transplant rejection in the kidney transplant population and improved general patient outcomes, including compliance. Positive service outcomes were also reported, including service feasibility, satisfaction and acceptance, as well as a reduction in hospitalisations, healthcare costs, and utilisation. CONCLUSION: RPM is being used across a range of outpatient service models in a variety of clinical specialties to deliver telepharmacy services. While more investigation is required, available evidence supports positive patient and service outcomes.