High intention but limited use: assessing the telepharmacy gap among patients with diabetes mellitus

Background Telepharmacy is defined as pharmaceutical care delivery through the use of telecommunications technology, which includes online or telephone‐based medication counselling, medication therapy management, assessment of drug‐related problems or follow‐up consultations offered via digital platforms like mobile applications, messaging systems or video calls. For people with diabetes mellitus, this involves real‐time chats, follow‐up messages and services, and educating patients on diabetes management. Aim This research investigated factors that influence patient intention to adopt telepharmacy and its correlation with actual usage among patients with diabetes mellitus in Puncak Alam, Malaysia. Method A cross‐sectional online survey was conducted from March to May 2025 using a 35‐item questionnaire that was based on the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology. Adults (aged ≥18 years) who had been diagnosed with diabetes mellitus (type 1 or type 2), were taking at least one anti‐diabetic medicine and were residing in Puncak Alam were eligible for inclusion. Ethical approval was granted by the Faculty of Pharmacy, Universiti Teknologi MARA Faculty Ethics Review Committee (Reference no: REC (PH)/UG/164/2024) and the study conforms with the Declaration of Helsinki. Informed consent was obtained from all participants via the distribution of study information and completion of written consent forms prior to their involvement in the study. Results A total of 361 patients completed the survey. Perceived usefulness (mean = 13.05) of telepharmacy, an intention to use telepharmacy (mean = 12.90) and the ease of use of telepharmacy (mean = 12.76) were rated highest by participants. Intention to use was higher in: individuals aged 40–55 years; those with bachelor's degrees; government employees; patients with longer diabetes duration; frequent healthcare visitors; and those who were already aware of telepharmacy. Predictors included medication count (ε 2 = 0.159), telepharmacy awareness (ε 2 = 0.119) and prior knowledge (ε 2 = 0.103). Despite strong intention, only 39.3% of participants had utilised telepharmacy services, with a moderate positive correlation between intention and use (ρ = 0.630, p < 0.001). Lack of awareness was the primary barrier (odds ratio [OR] = 7.48, 95% confidence interval [CI] 4.35–12.85, p < 0.001), followed by having three or more medicines (OR = 2.63, 95% CI 1.78–3.88, p < 0.001). Conclusion A significant intention–behaviour gap exists and closing this gap requires enhancing patient awareness, integrating telepharmacy into standard diabetes care and simplifying the registration process particularly targeting patients with lower education attainment and simple medicine regimens.