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• W131655607 abstract "The provision of quality pharmacy services to rural and remote communities is influenced by theNational Strategy for the Quality Use of Medicines. The implementation of National Medicines Policyis challenged by the shortage of pharmacists in rural areas. Australia compares unfavourably with boththe United Kingdom and the USA in this regard. The study by the Department of Employment andWorkplace Relations in 2002 identified that there is a severe shortage of hospital pharmacists in NewSouth Wales and acute shortages of community pharmacists in Queensland regional areas.Although the lack of a telecommunications infrastructure has been a major impediment to theextension of telehealth into rural Australia, the challenge of delivering pharmaceutical services intorural areas may be augmented by the provision of telepharmacy applications such as remotedispensing of medications, counselling and implementing medication reviews by video conferencing.The aims of this thesis were to ascertain the opinions of relevant healthcare professionals to theconcepts of telepharmacy; to identify the requirements of a telepharmacy system suitable for use inrural Australia; to develop a pilot telepharmacy system and to demonstrate the system by dispensing alimited range of products locally and then remotely via telecommunications. Thereafter, to identify anarea of telepharmacy where there is a clinical need and to demonstrate the applicability oftelepharmacy by means of a trial involving volunteer patients.This study initially involved interviewing healthcare workers in northern Queensland, the TiwiIslands, and the western coast of Tasmania to assess the receptiveness, requirements and potential fortelepharmacy applications in rural and remote regions in Australia.Thereafter a comprehensive literature search on telepharmacy applications was conducted with a viewto identifying suitable equipment for use in rural Australia. Whilst the search revealed a number ofexamples of commercial telepharmacy applications in the USA and Europe, none met all of thedefined criteria for an ideal rural Australian telepharmacy system.Accordingly, two pilot telepharmacy systems were developed and constructed, based upon theidentified criteria. For remote controlled operations under video supervision, the criteria for atelepharmacy application were defined as:• a system capable of storing a range of individual medications to suit the intended application;• a standard commercial dispensary computer program;• an automated method of removing individual packs from the storage unit;• an image acquisition device to capture and store a picture of the dispensed pack, and• a bar code reader to record the bar code of the dispensed product.In addition, video conferencing capability was required to enable the remote pharmacist to providecounselling and medication review services to the patient.Four trials were conducted using the constructed pilot telepharmacy equipment to demonstrate thevalidity, accuracy and reliability of the systems in dispensing a limited range of products locally andthen remotely via telecommunications. These studies adequately demonstrated the operation of thetelepharmacy dispensing systems and identified the requirement for a different design of bar codereader in any further trials. These studies also identified that the inclusion of video conferencing in asingle remote telepharmacy application was not the optimum solution and that a separate videoconferencing unit was required. A simple system of quality assurance, incorporating a dispensed packimage acquisition and bar code verification was also demonstrated, resulting in the addition of asignificant patient safety factor to mitigate dispensing errors.In order to ascertain the level of support for the concept of telepharmacy and its potential applications,four key healthcare professional groups in rural northern Australia were surveyed. Pharmacists andmedical practitioners were surveyed by post and the nurse group was surveyed at the 2006 RoyalCollege of Nursing annual conference in Cairns. The nurse/healthcare group was an online Internetsurvey, advertised in the Nursing Careers and Allied Health booklet published in June 2006. Themajor findings were that 87 per cent of all the healthcare respondents supported the use oftelepharmacy to provide professional pharmaceutical services to rural and remote areas of Australia.The study did, however, identify that 70 per cent of the pharmacist group surveyed were notsupportive, or neutral to, the use of remotely operated automated dispensing equipment as atelepharmacy application in rural areas, when the local pharmacy was closed. The pharmacist groupwere also not supportive of the use of such equipment in remote areas where there was no communitypharmacy (58 per cent disagreed or were neutral). These results were further analysed and revealedthat the younger pharmacist age group (less than 10 years experience), were in favour of the use of theautomated dispensing equipment as a telepharmacy application, where there was no communitypharmacy, compared to the older pharmacist group (P< 0.05).Medication reviews are a key objective of the Fourth Community Pharmacy Agreement and areprovided as a fee for service basis for face to face reviews conducted in the home. They wereidentified in the surveys as a clinical need which may be solved by a telepharmacy application due tothe difficulty and expensive of providing medication reviews to patients in rural and remote areas.A pilot study involving volunteer patients was conducted to demonstrate the use of a telepharmacyapplication in conducting medication reviews. The study recruited nine patients and the medicationreviews were conducted by an accredited pharmacist via a local area wireless network, equivalent to aBroadband Internet connection. The telepharmacy interviews were recorded and provided valuableinformation for the pharmacist preparing the medication management reports. The patients were askedto complete a customer satisfaction questionnaire on conclusion of the video conference. Six of thepatients rated the overall telepharmacy experience as excellent and three rated the experience as verygood.Whilst not removing, or negating, the need for personal professional pharmacy services, there aremany potential benefits for telepharmacy applications directed at rural communities. However, it isimportant that it includes and retains the active role of the pharmacist in the delivery of pharmacyservices to achieve the highest quality of care for rural communities and for the safety, and welfare ofthe public related to the use of pharmaceuticals. Pharmacist involvement is essential for patientcounselling and medication reviews, with their exclusion increasing risks to the patient and leading toa higher incidence of medication errors, adverse events, and excessive drug costs. The study has thusprovided evidence that telepharmacy applications may potentially lead to unique and innovative waysto deliver quality pharmacy services to rural and remote areas." @default.
• W131655607 created "2016-06-24" @default.
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• W131655607 date "2007-01-01" @default.
• W131655607 modified "2023-09-27" @default.
• W131655607 title "The application of telepharmacy as an enabling technology to facilitate the provision of quality pharmaceutical services to rural and remote areas of Australia" @default.
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