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Telepharmacy Knowledge, Perceptions, and Readiness among Future Malaysian

Pharmacists Amid the COVID-19 Pandemic

Article · January 2022

DOI: 10.5530/ijper.56.1.2

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 Original Article

Telepharmacy Knowledge, Perceptions, and

Readiness among Future Malaysian Pharmacists
Amid the COVID-19 Pandemic
Mohamed Hassan Elnaem1,2,* Muhammad Eid Akkawi1,2, Abdul Kareem Al-Shami1,2,
Ramadan Elkalmi3,4
1
Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University-Malaysia, Kuantan, Pahang, MALAYSIA.
2
Faculty of Pharmacy, Quality Use of Medicines Research Group, International Islamic University-Malaysia, Kuantan,
Pahang, MALAYSIA.
3
Department of Clinical Pharmacy and Therapeutics, Dubai College of Pharmacy, Dubai, UAE.
4
Faculty of Medicine, University of Sebha, Sabha, LIBYA.

ABSTRACT
Background: Telepharmacy is a relatively recent advancement in healthcare services
that enables providing high-quality pharmacy services to rural and remote areas. It
gained increased attention during the COVID19 pandemic. Objectives: To assess the
knowledge, perceptions, and readiness towards telepharmacy services among senior
pharmacy students in a Malaysian public pharmacy school. Materials and Methods: A
cross-sectional study was conducted using a self-developed, pre-tested, and validated
35-item questionnaire among penultimate and final year students in a Malaysian public
pharmacy school. Ethical approval was obtained before beginning the online data
collection between September and December 2020. Descriptive and inferential data
analyses were performed using SPSS version 22. A p-value ≤ of 0.05 was considered
statistically significant. Results: The study received a total of 178 responses to the
questionnaire. The response rates of the third and fourth years were 50.6% and 49.4%,
respectively. Overall, 67% had high knowledge, and 68% showed high readiness level.
Meanwhile, 61% of the responses had positive perceptions of telepharmacy services.
A notably excellent knowledge was demonstrated in items related to the telepharmacy
role during the pandemic (93.8%) and the technical competencies required for the
service provider (96.1%). The beneficial role of telepharmacy to save patients’ resources Submission Date: 07-06-2021;
was perceived positively with a 91% agreement level among study participants. The Revision Date: 07-09-2021;
readiness items related to the lack of incentive and the excessive workload were Accepted Date: 09-11-2021.
associated with less agreement levels of 33.7% and 45.5%, respectively. Overall,
DOI: 10.5530/ijper.56.1.2
participants’ knowledge of telepharmacy significantly impacted their expressed readiness Correspondence:
to implement telepharmacy services in their future practice. Conclusion: Most study Dr. Mohamed Hassan
participants had adequate knowledge, positive perceptions and demonstrated readiness Elnaem, Pharm.D, PhD.
to implement telepharmacy services in their future pharmacy practice. The potential Assistant Professor, Pharmacy
Practice Department, Faculty
increase in workload and lack of incentive were the main concerns associated with the
of Pharmacy, International
widespread adoption of telepharmacy practice models. Islamic University-Malaysia,
Key words: Malaysia, Pharmacists, Readiness, Students, Telepharmacy. Jalan Sultan Ahmad
Shah-25200 Kuantan,
Pahang, MALAYSIA.
INTRODUCTION E-mail: drmelnaem@iium.
edu.my
The term “Telemedicine” was introduced and support healthcare systems when
in the 1960s and has expanded to include patients are disconnected due to distance.2
all communication technology forms to According to the American Society of
ensure that health care and public education Health-System Pharmacists (ASHP),
are provided in the countryside and remote telepharmacy refers to pharmacists’ use
areas.1 The Institute of Medicine defines of telecommunications technology to
telemedicine as “the use of information and monitor pharmacy operations and deliver
communication technology (ICT) to deliver patient care services.3 It appears to be a new www.ijper.org

Indian Journal of Pharmaceutical Education and Research | Vol 56 | Issue 1 | Jan-Mar, 2022 9
 Elnaem, et al.: Telepharmacy Readiness among Future Malaysian Pharmacists

platform that provides a unique and advanced method their knowledge, perceptions, and readiness towards
of providing quality pharmacy services to rural and telepharmacy.
remote areas.4 Common telepharmacy services include Study Subjects and Settings
medication order review, dispensing medications,
patient consultation and evaluation, therapeutic drug The study was conducted through an online survey using
monitoring, and medication therapy management.5 Google Forms among pre-final and final year pharmacy
These services can be conducted using electronic students in one of the main Malaysian public universities.
technology tools such as video conferencing, new We focused on senior undergraduate pharmacy students
systemic software applications, and automatic dispensing because they were exposed adequately to the core
machines.6 Telepharmacy addresses access to healthcare pharmacy practice courses. Additionally, participants
services while also increasing the effectiveness of patient must understand English, as the online survey was
counseling provided by pharmacists through remote conducted in the English language. The subject’s
area networks.7 Also, it was found that telepharmacy participation was voluntary, and no compensation was
offers better counseling in terms of privacy and session provided.
length and provides cost-effective health care services.8 Sample Size
Telepharmacy services gained more attention to allow
The sample size was calculated using the Raosoft
remote pharmaceutical care services during the COVID-
calculator. The confidence level, the margin of error,
19 pandemic, where several movement restrictions have
and the response distribution were set at 95%, 5%, and
been implemented globally.9 Therefore, the issue of
50%, respectively. Following the final calculation, the
the readiness of future health care providers to adopt
minimum recommended sample size for our study is
the telepharmacy practice model needs to be further
151 respondents.
investigated. Several initiatives in pharmacy programs
have focused on improving learners’ communication Study Procedure
skills.10 Previous reports showed that incorporating Formal ethical permission was obtained from the
telepharmacy services into training programs for IIUM Research Ethics Committee (IREC) before the
pharmacy students and integrating technology into collection of data. Due to the COVID-19 pandemic,
pharmacy has expanded the understanding of drug online questionnaires have been chosen as the platform
therapy problems and their ability to communicate to communicate with the study participants. Therefore,
patient care plans.11,12 Moreover, strategies for Google Form, an online survey platform, was used to
appropriate technology-based education and training distribute the questionnaires.
are still needed among students and practitioners.13 In
Malaysia, the Ministry of Health initiated services such Study Instrument
as teleconsulting and personalized health information in A self-designed 35-item structured questionnaire was
a plan towards implementing telemedicine.14 Therefore, developed as no valid instrument was found in the
future health care providers should be equipped literature. Three pharmacy academicians reviewed the
with essential knowledge and skills for successful content validity of the questionnaire after considering
telepharmacy implementation.15 There is a scarcity their experience and knowledge of the research topic.
of information on the level of knowledge, beliefs, Since the validation process involved three pharmacy
and preparedness for telepharmacy among pharmacy academicians, the acceptable item-level content validity
students nearing graduation. Therefore, the purpose of index was 1. After considering all the experts’ inputs,
this study was to assess the knowledge, perception, and the final survey was reduced from 54 to 35 items. The
readiness towards telepharmacy services among senior survey was composed of four sections; section A for
pharmacy students at a Malaysian public pharmacy demographic information; section B, which consisted
school. of 10 items for knowledge measured on a true, false,
and not sure scale; section C, which contained 13 items
MATERIALS AND METHODS for perceptions; and section D, which included 12 items
for readiness. Responses for both perceptions and
Study Design readiness were collected on a 5-item Likert scale. At the
A cross-sectional study was conducted from September researchers’ discretion, the total score of each section
to December 2020 among senior pharmacy students was used to categorize responses into low ≤ 40%,
in a Malaysian public pharmacy school to assess medium 41%-74%, and high ≥ 75%.
10 Indian Journal of Pharmaceutical Education and Research | Vol 56 | Issue 1 | Jan-Mar, 2022
 Elnaem, et al.: Telepharmacy Readiness among Future Malaysian Pharmacists

Statistical Analysis their knowledge of telepharmacy are presented in Table

The data were analyzed using SPSS software, version 22. 1.
The descriptive data were analyzed using percentages Students’ perceptions of telepharmacy
and frequencies. The Chi-square test was used to On average, 61% of the responses showed positive
see whether third-year and fourth-year students’ perceptions towards telepharmacy. Three items showed
questionnaire responses differed significantly. In less than 50% agreement level on the measurement
addition, the Mann-Whitney U test was used to scale, such as the effectiveness of patient consultation
investigate potential associations between knowledge via telepharmacy (40.4%). Meanwhile, the highest
and readiness items. The level of significance was set at agreement level (91%) was related to the item focusing
p<0.05. on the beneficial role of telepharmacy in saving patients’
resources. Most items revealed no significant difference
RESULTS in favorable telepharmacy implementation in Malaysia
between the third and fourth-year students. Table 2
Demographic information displays the responses related to the perceptions of
The study received 178 responses to the questionnaire, students regarding telepharmacy.
exceeding the minimum required sample with 27 Students’ readiness toward telepharmacy and its
responses. The response rates for the third and fourth associations with knowledge level
years were 50.6% and 49.4%, respectively. Overall, 67% Table 3 shows the overall responses to the 12 items
had high knowledge, and 68% showed a high readiness in Section D of the readiness assessment. The
level. Meanwhile, 61% of the responses had positive participants reported, on average, 68% readiness
perceptions of telepharmacy services. towards telepharmacy implementation and its
Students’ knowledge on telepharmacy
associated requirements. The items related to the lack
of incentive and the excessive workload were associated
For this section, the overall average level of knowledge with less readiness among participants, with agreement
among study participants was 67%. Overall, there were levels of 33.7% and 45.5%, respectively. The highest
no significant differences based on years of study, except expressed readiness levels were linked to participants’
for the first item related to the status of telepharmacy willingness to undertake required training and use of
practice in Malaysia (p = 0.001). In addition, notably mobile technology in their future telepharmacy practice.
excellent knowledge was demonstrated in items related Furthermore, the findings showed significant
to the telepharmacy role during the pandemic (93.8%) associations between knowledge and readiness items.
and the technical competencies required for the service Overall, participants’ knowledge of telepharmacy
provider (96.1%). The responses of students regarding significantly impacted their expressed readiness to

Table 1: Responses to telepharmacy knowledge items (n=178).

Not sure, Yes
No N (%)
N (%)
K1. Telepharmacy is available in Malaysia 81(45.5) 97(54.5)
K2. Information Communication Technology (ICT) knowledge is important for pharmacists on how to 7(3.9) 171(96.1)
conduct telepharmacy.
K3. Telepharmacy played a big role during COVID-19 outbreak around the world. 11(6.2) 167(93.8)
K4. Telepharmacy does require strong internet connection or high-performance technology. 54(30.3) 124(69.7)
K5. Telepharmacy provides better counseling in terms of privacy and length of the session. 76(42.7) 102(57.3)
K6. Telepharmacy solves the waiting time problem in most general hospitals. 17(9.6) 161(90.4)
K7. Telepharmacy is also involved in ADR monitoring and reporting. 60(33.7) 118(66.3)
K8. In general hospitals, telepharmacy is conducted by drug information service during office hours and by 56(31.5) 122(68.5)
emergency departments after office hours.
K9. Patients from rural areas can have more medication access and information via telepharmacy. 60(33.7) 118(66.3)
K10. Telepharmacy services can extend hospital pharmacy services outside office hours that do not offer 46(25.8) 132(74.2)
round-the-clock pharmacy services.

Indian Journal of Pharmaceutical Education and Research | Vol 56 | Issue 1 | Jan-Mar, 2022 11
 Elnaem, et al.: Telepharmacy Readiness among Future Malaysian Pharmacists

Table 2: Responses to telepharmacy perceptions items (n=178).

Strongly Neutral Strongly
disagree, N (%) agree, Agree
Disagree N (%)
N (%)
P1. Do you think telepharmacy will improve the patient’s adherence to the medication? 6(3.4) 33 (18.5) 139(78.1)
P2. Do you agree telepharmacy will have a higher error rate for medication dispensing 31(17.4) 88(49.4) 59(33.1)
and filling, as compared to traditional pharmacy?
P3. Do you feel telepharmacy will enhance the patient’s access to the medication, 13(7.3) 29(16.3) 136(76.4)
especially those who are in rural areas?

P4. Do you think telepharmacy will provide the complete privacy setting during the 11(6.2) 39(21.9) 128(71.9)
consultation period?

P5. Based on your opinion, do you agree telepharmacy will increase the pharmacist’s 19(10.7) 64(36.0) 95(53.4)
workload and commitment?

P6. Do you think telepharmacy is able to help patients save their money and travel 0(0) 16(9.0) 162(91.0)
time to reach the healthcare facilities?
P7. Are you willing to share your personal information on the online database when 22(12.4) 58(32.6) 98(55.1)
using telepharmacy services?
P8. Do you think telepharmacy can minimize the cost to establish pharmaceutical 12(6.7) 59(33.1) 107(60.1)
business in comparison to regular pharmacy?
P9. Do you think patient consultation via telepharmacy will be effective? 36(20.2) 70(39.3) 72(40.4)
P10. Do you think pharmacy schools should provide education programs on 4(2.2) 26(14.6) 148(83.1)
computers, IT, and telepharmacy to assist in future utilization of telepharmacy?
P11. Do you think therapeutic drug monitoring via telepharmacy in rural areas will be 71(39.9) 54(30.3) 53(29.8)
easily monitored?
P12. Do you agree that security is a greater concern in a remote site telepharmacy 9(5.1) 48(27.0) 121(68.0)
than in a traditional community pharmacy?
P13. Scarcity of pharmacists has caused a situation where medications are supplied 22(12.4) 64(36.0) 92(51.7)
without the involvement of pharmacists. Do you agree that telepharmacy is able to
help to minimize this scarcity?

Table 3: Responses to telepharmacy readiness items (n=178).

Strongly Neutral Strongly
disagree, N (%) agree,
Disagree Agree
N (%) N (%)
R1. I am ready to work on telepharmacy projects in rural areas, even without an incentive. 55(30.9) 63(35.4) 60(33.7)
R2. I am ready to work after office hours if needed. 33(18.5) 64(36.0) 81(45.5)
R3. I am ready to conduct drug counseling via two-way video consultation such as 6(3.4) 26(14.6) 146(82.0)
telephone call, text message, or voice call through mobile applications.
R4. I am ready to teach the patients how to use their drug delivery device (e.g., inhaler, 10(5.6) 35(19.7) 133(74.7)
insulin pen) properly through video consultation.
R5. I am ready to undergo training in ethics and legal issues related to telepharmacy. 4(2.2) 24(13.5) 150(84.3)
R6. I am ready to face the implementation of telepharmacy in all healthcare settings. 1(0.6) 39(21.9) 138(77.5)
R7. I am ready to conduct Home Medication Review (HMR) through telepharmacy, 15(8.4) 38(21.3) 125(70.2)
especially in rural and remote communities.
R8. I am ready to improve and reduce the risk of medication errors among patients through 5(2.8) 34(19.1) 139(78.1)
telepharmacy.
R9. I am ready to carry the increment of workload when conducting telepharmacy. 24(13.5) 74(41.6) 80(44.9)
R10. I am ready to conduct medication reconciliation via telepharmacy services. 8(4.5) 50(28.1) 120(67.4)
R11. I am ready to perform remote prescription checking before dispensing drugs from an 9(5.1) 41(23.0) 128(71.9)
automated medication dispensing cabinet.
R12. I am ready to use mobile applications and the Internet to receive refill orders from 1(0.6) 27(15.2) 150(84.3)
patients and transfer prescriptions.

12 Indian Journal of Pharmaceutical Education and Research | Vol 56 | Issue 1 | Jan-Mar, 2022
 Elnaem, et al.: Telepharmacy Readiness among Future Malaysian Pharmacists

Table 4: Associations between knowledge and readiness items.

Independent knowledge items Dependent readiness items P-value*
K3. Telepharmacy played a big role during COVID-19 outbreak R4. I am ready to teach the patients how to use 0.026
around the world. their drug delivery device (e.g., inhaler, insulin pen)
properly through video consultation.
R6. I am ready to face the implementation of 0.001
telepharmacy in all healthcare settings.
R7. I am ready to conduct Home Medication Review 0.002
(HMR) through telepharmacy, especially in rural and
remote communities.
R8. I am ready to improve and reduce the risk 0.031
of medication errors among patients through
telepharmacy.
R9. I am ready to carry the increment of workload 0.005
when conducting telepharmacy.
R12. I am ready to use mobile applications and the 0.001
Internet to receive refill orders from patients and
transfer prescriptions.
K5. Telepharmacy provides better counseling in terms of privacy R7. I am ready to conduct Home Medication Review 0.031
and length of the session. (HMR) through telepharmacy, especially in rural and
remote communities.
K6. Telepharmacy solves the waiting time problem in most R6. I am ready to face the implementation of 0.003
general hospitals. telepharmacy in all healthcare settings.
R12. I am ready to use mobile applications and the 0.006
Internet to receive refill orders from patients and
transfer prescriptions.
K7. Telepharmacy is also involved in ADR monitoring and R6. I am ready to face the implementation of 0.015
reporting. telepharmacy in all healthcare settings.
K8. In general hospitals, Telepharmacy is conducted by drug R2. I am ready to work after office hours if needed. 0.009
information service during office hours and by emergency R3. I am ready to conduct drug counseling via two- 0.013
departments after office hours. way video consultation such as telephone call, text
message, or voice call through mobile applications.
K9. Patients from rural areas can have more medication access R2. I am ready to work after office hours if needed. 0.038
and information via Telepharmacy.
R6. I am ready to face the implementation of 0.041
telepharmacy in all healthcare settings.
*Mann-Whitney U test

implement telepharmacy services in their future knowledge about telepharmacy, indicating the same
practice. For example, recognizing the potential role level of exposure to academic subjects closely related to
of telepharmacy in providing remote pharmaceutical telepharmacy. There was some variation and uncertainty
care services during the pandemic (K3) was linked in responses to the first item regarding the availability
to an increase in six readiness domains to implement of telepharmacy in Malaysia, which could be explained
and undertake all the provider-related roles. Also, by the fact that it has not yet been fully developed and
the knowledge of telepharmacy benefits (K6) was made widely available. The first attempt to involve
significantly associated with the readiness to implement pharmacists in virtual health care services was initiated
telepharmacy considering all its technological in a collaborative program with the World Health
requirements. A detailed explanation of the correlated Organization (WHO) to develop Drug Information
items between the knowledge and readiness sections is Services (DIS) through a virtual network.16 Most
presented in Table 4. participants emphasized the importance of Information
Communication Technology (ICT) knowledge for
DISCUSSION pharmacists to conduct telepharmacy. It can be supported
This study explored the senior pharmacy students’ by previous research, which reported that more than
knowledge, perceptions, and readiness for telepharmacy 50% of healthcare providers agreed that ICT knowledge
services. It was found that students in their third determined their attitudes towards telepharmacy.17
and fourth years have roughly comparable levels of Hence, ICT knowledge is crucial for pharmacists to
Indian Journal of Pharmaceutical Education and Research | Vol 56 | Issue 1 | Jan-Mar, 2022 13
 Elnaem, et al.: Telepharmacy Readiness among Future Malaysian Pharmacists

understand and implement better telepharmacy services are more towards service payment and reimbursement
to improve patients’ outcomes when implementing such issues.15 Security was considered by most students to
services. The findings also highlighted the significant be a greater concern in telepharmacy than in traditional
role that telepharmacy played during the COVID-19 community pharmacies. Again, this could be attributed
pandemic. Many healthcare providers use telepharmacy to a lack of previous experience in telepharmacy services.
services to improve patient access to pharmaceutical Furthermore, the students agreed that pharmacy schools
care, allowing for more efficient delivery of care and should offer education programs in computer science,
reducing medication errors.18 Regarding the clinical information technology, and telepharmacy in preparation
benefits of telepharmacy, the findings revealed that for future telepharmacy use, which corresponds to
most students agreed that telepharmacy could improve an Italian study that established the importance of IT
medication access for patients in rural areas. Similar knowledge for pharmacy students to equip them with
data were provided in a cross-sectional study to assess essential skills for their future professional practice.22
pharmacists’ perspectives in hospitals and community The evidence is also supported by another study that
pharmacies on the clinical benefit and challenges of mentioned that the quality of technology provided,
telepharmacy.19 Medication access and information reliable internet connections, and optimal utilization of
in rural areas via telepharmacy would help eliminate the technology could influence telepharmacy services.19
prominent barriers such as travel time and expense and Concerning their readiness to implement telepharmacy
subsequently improve patient trust and satisfaction with services in their future practice, there was a consistent
telepharmacy service. agreement among study participants to undertake all
In general, study participants had positive perceptions activities and training relevant to telepharmacy practice.
of implementing telepharmacy in Malaysia since This could indicate the proper understanding of the
telepharmacy could enhance students’ preparation to potential role that telepharmacy could have in the
determine patient care interventions. The perceptions future pharmacy practice models nationally, particularly
of the future pharmacists in our study contradicted amid the COVID-19 pandemic.23,24 Interestingly, most
what has been highlighted among healthcare providers of the students were ready to carry the increment in
in critical care who reported skepticism and uncertainty workload when conducting telepharmacy. However,
about the efficiency of telemedicine to deliver quality they expressed their concern about the lack of incentive
patient care.20 Affected by a lack of prior experience, for extended telepharmacy services, as most students
some participants agreed with the statement that would not agree to work on telepharmacy projects
telepharmacy would possibly be associated with a higher without incentive. In an Iranian study conducted to
medication error rate. Previous research highlighted that explore pharmacists’ views on telepharmacy, the same
prior exposure was essential for pharmacy students to issue of incentive and reimbursement has emerged as a
know whether telepharmacy would be related to a higher significant barrier for the telepharmacy practice model.15
error rate or not.19 As highlighted earlier, telepharmacy Consequently, a sustainable telepharmacy practice model
could help decrease medication error rates, improve the should carefully consider essential training, balanced
quality of private counseling, and provide new channels workload, and reimbursement for service providers.
for education programs.21 Participants’ perceptions of This work is not without limitations. First, the survey
the telepharmacy service appear favorable, but they was answered by participants who belonged to one
remain uncertain about the scope of potential benefits university, so the generalizability of the findings is
and consequences. Most of the students believed that uncertain. Second, little work was conducted among
telepharmacy could minimize the current scarcity of senior pharmacy students that restricted us from
pharmacists. This perception is supported by studies properly comparing our findings to others.
that discovered telepharmacy as a solution to the
pharmacy workforce shortage, in which pharmaceutical
services are provided remotely.21 Nonetheless, CONCLUSION
respondents were skeptical about the possibility of Most study participants had adequate knowledge,
applying particular services such as therapeutic drug positive perceptions and demonstrated readiness
monitoring through telepharmacy. Also, participants to implement telepharmacy services in their future
appeared to be concerned about the potential increase pharmacy practice. However, they expressed concerns
in the usual workload imposed by telepharmacy service about the potential for an increased workload and a lack
components, which they saw as barriers. However, other of incentive associated with the widespread adoption of
evidence highlights that telepharmacy practice barriers telepharmacy practice models. It is suggested that the
14 Indian Journal of Pharmaceutical Education and Research | Vol 56 | Issue 1 | Jan-Mar, 2022
 Elnaem, et al.: Telepharmacy Readiness among Future Malaysian Pharmacists

sustainable telepharmacy practice model should carefully 6. Keeys C, Kalejaiye B, Skinner M, Eimen M, Neufer JA, Sidbury G, et al.
Pharmacist-managed inpatient discharge medication reconciliation: A
consider the essential training, balanced workload, and combined onsite and telepharmacy model. American Journal of Health-
reimbursement for service providers. This study may System Pharmacy. 2014;71(24):2159–66.
support the future implementation of telepharmacy 7. Omran S, Elnaem MH, Ellabany N. Telepharmacy Knowledge, Attitude and

pharmaceutical care services in full capacity in Malaysia. Practice among Egyptian Pharmacists amid the COVID-19 Pandemic. In
American College of Clinical Pharmacy; 2021 [cited 2021 Nov 3]. Available
Also, it might aid academic initiatives in expanding the from: https://accp.confex.com/accp/2021am/meetingapp.cgi/Paper/57976
inclusion of telepharmacy practice models as a subject 8. Garrelts JC, Gagnon M, Eisenberg C, Moerer J, Carrithers JOE. Impact of
course in the curriculum, thereby better preparing future telepharmacy in a multihospital health system. American Journal of Health-
System Pharmacy. 2010 Sep;67(17):1456–62.
healthcare providers to perform their role effectively in 9. Hedima EW, Okoro RN. Telepharmacy: An opportunity for community
delivering telepharmacy services. pharmacists during the COVID-19 pandemic in Sub Saharan Africa. Health
Policy and Technology. 2020;
Funding 10. Elnaem MH, Jamshed SQ, Elkalmi RM. The future of pharmaceutical care

This study was supported by grant no. in Malaysia : Pharmacy students ’ perspectives. Pharmacy Education.
2017;17(1):215–22.
RC-RIGS20-006-0006 from research management 11. Smith MA, Benedict N. Effectiveness of educational technology to
center, International Islamic University Malaysia. improve patient care in pharmacy curricula. Vol. 79, American Journal of
Pharmaceutical Education. American Association of Colleges of Pharmacy;
2015. p. 1–10.
ACKNOWLEDGEMENT 12. Alfaar AS, Kamal S, Abouelnaga S, Greene WL, Quintana Y, Ribeiro RC, et al.
International telepharmacy education: Another venue to improve cancer care
The authors acknowledge the contribution in the data in the developing world. In: Telemedicine and e-Health. Mary Ann Liebert,
collection phase made by Mr. Muhammad Adib Aqmal, Inc.; 2012. p. 470–4.
Mr. Muhammad Hafiz Abd Rahim, Mr. Mohammad 13. Elnaem MH, Jamshed S. Mobile applications in clinical practice: What

Adam Al-haqimy, Mr. Mohammad Aizat Hakim, Mr. is needed in the pharmacy scenario? Archives of Pharmacy Practice
[Internet]. 2017;8(1):3. Available from: http://www.archivepp.com/text.
Amri Nurhakim, Ms. Nadhrah Syamimi, Ms. Nur Shadia, asp?2017/8/1/3/199619
and Ms. Nurul Hanis Mohd Sabari. 14. Mat Som MH, Norali AN, Megat Ali MSA. Telehealth in Malaysia - An
overview. ISIEA 2010 - 2010 IEEE Symposium on Industrial Electronics and
Applications. 2010;660–4.
CONFLICT OF INTEREST 15. Ameri A, Salmanizadeh F, Keshvardoost S, Bahaadinbeigy K. Investigating
Pharmacists’ Views on Telepharmacy: Prioritizing Key Relationships,
The authors declare no conflict of interest. Barriers, and Benefits. Journal of Pharmacy Technology [Internet]. 2020 Oct 7
[cited 2021 Apr 28];36(5):171–8. Available from: http://journals.sagepub.com/

ABBREVIATIONS doi/10.1177/8755122520931442
16. Syed Azhar SS, Rahmat A, Jamal M. Malaysia Pharmaceutical Society -
WHO: World Health Organization; DIS: Telepharmacy. 2002.

Drug Information Services; ICT: Information 17. GSJ DE-, 2017 undefined. Knowledge and Attitude of The Physicians Toward
Telemedicine. GlobalscientificjournalCom. 2017;5(June).
Communication Technology; ASHP: American Society 18. Ibrahim OM, Ibrahim RM, Z Al Meslamani A, Al Mazrouei N. Role of
of Health-System Pharmacists. telepharmacy in pharmacist counselling to coronavirus disease 2019 patients
and medication dispensing errors. Journal of Telemedicine and Telecare.
2020;
REFERENCES 19. Poudel A, Nissen L. Telepharmacy: a pharmacist&rsquo;s perspective on the
1. Angaran DM. Telemedicine and telepharmacy: Current status and future clinical benefits and challenges. Integrated Pharmacy Research and Practice.
implications. Vol. 56, American Journal of Health-System Pharmacy. 2016 Oct;Volume 5:75–82.
American Society of Health-Systems Pharmacy; 1999. p. 1405–26. 20. Shahpori R, Hebert M, Kushniruk A, Zuege D. Telemedicine in the intensive
2. Rawashdeh M, al Zamil MG, Hossain MS, Samarah S, Amin SU, Muhammad care unit environment-A survey of the attitudes and perspectives of critical
G. Reliable service delivery in Tele-health care systems. Journal of Network care clinicians. Journal of Critical Care. 2011;26(3):328.e9-328.e15.
and Computer Applications. 2018 Aug 1;115:86–93. 21. Baldoni S, Amenta F, Ricci G. Telepharmacy services: Present status and
3. Alexander E, Butler CD, Darr A, Jenkins MT, Long RD, Shipman CJ, et al. future perspectives: A review. Medicina (Lithuania). 2019;55(7).
ASHP Statement on telepharmacy. American Journal of Health-System 22. Sankaranarayanan J, Murante LJ, Moffett LM. A Retrospective Evaluation of
Pharmacy [Internet]. 2017 May 1 [cited 2020 May 21];74(9):e236–41. Remote Pharmacist Interventions in a Telepharmacy Service Model Using a
Available from: https://academic.oup.com/ajhp/article/74/9/e236/5102780 Conceptual Framework. Telemedicine and e-Health. 2014 Oct;20(10):893–
4. Kimber MB, Peterson GM. Telepharmacy-Enabling Technology to Provide 901.
Quality Pharmacy Services in Rural and Remote Communities. Journal of 23. Le T, Toscani M, Colaizzi J. Telepharmacy: A New Paradigm for Our
Pharmacy Practice and Research. 2006 Jun;36(2):128–33. Profession. Journal of Pharmacy Practice. 2020;33(2):176–82.
5. Margolis A, Young H, Lis J, Schuna A, Sorkness CA. A telepharmacy 24. Elnaem MH, Cheema E. Caring for patients with diabetes during COVID-19
intervention to improve inhaler adherence in veterans with chronic obstructive pandemic: Important considerations for pharmacists. Research in social &
pulmonary disease. Vol. 70, American Journal of Health-System Pharmacy. administrative pharmacy : RSAP [Internet]. 2020;(May):0–1. Available from:
American Society of Health-Systems Pharmacy; 2013. p. 1875–6. http://www.ncbi.nlm.nih.gov/pubmed/32507575.

Indian Journal of Pharmaceutical Education and Research | Vol 56 | Issue 1 | Jan-Mar, 2022 15
 Elnaem, et al.: Telepharmacy Readiness among Future Malaysian Pharmacists

PICTORIAL ABSTRACT SUMMARY

• Participants had good knowledge and

understanding of how telepharmacy services
could be used in their future pharmacy practice.
• Participants had positive perceptions of the
telepharmacy service, but they were uncertain
about the scope of potential benefits and
consequences.
• There was widespread agreement among study
participants to participate in all telepharmacy-
related activities and training to implement
telepharmacy services in their future practices.
They were concerned, however, about the
workload and lack of incentives that came with it.

About Authors

Dr. Mohamed Hassan Elnaem is a Pharmacy academician with ten years of experience working
in higher education institutions. He is a clinical pharmacy educator with prior practice experience
and an active researcher in the areas of quality use of medicines and experiential pharmacy
education. Presently, he is working as an Assistant Professor in the Department of Pharmacy
Practice, Faculty of Pharmacy, International Islamic University Malaysia.

Cite this article: Elnaem MH, Akkawi ME, Al-shami AK, Elkalmi R. Telepharmacy Knowledge, Perceptions, and
Readiness among Future Malaysian Pharmacists Amid the COVID-19 Pandemic. Indian J of Pharmaceutical
Education and Research. 2022;56(1):9-16.

16 Indian Journal of Pharmaceutical Education and Research | Vol 56 | Issue 1 | Jan-Mar, 2022

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