Keywords: tele-health, tele-pharmacy, rural, general practice

Background:

Remote consulations are common in the provision of primary care to rural populations in the out of hours period, but mean access to medication can be challenging.

Aim of the study:

To develop, implement and evaluate a technological solution to provide access to urgently required medication following an out of hours tele-consultation

Methodology:

A researcher was embedded within the North Wales GP Out of hours (GPOOH) service as they worked with industry to develop and implement a medication machine, the Pharmaself REMEDY machine in the North Wales GPOOH service. Patton’s developmental evaluation was used within Stakes’s case study approach to evaluate against Greenhalgh’s NASSS framework.

Results:

The technology required significant modifications to suit this new use case and patient group, including the development of a new user interface for both clinicians and patients. While navigating the broader system was challenging, it was achievable with the support of senior stakeholders, particularly in securing the necessary regulatory approvals. Organizational constraints, such as financial limitations, restricted capital funding, and concerns around cybersecurity and information governance, led to considerable delays in the anticipated timeline. Adoption attitudes varied among groups; patients and the pharmacy team were highly enthusiastic and eager to use the technology, whereas clinicians were more hesitant. Notably, patient demand played a crucial role in encouraging clinician adoption. The overall value of the machine is still under evaluation. Patients perceive significant benefits, particularly in reducing their need for travel, but the broader health system remains uncertain about its overall impact. We anticipate having further results by the time of the conference, particularly in the areas of condition management, integration, and long-term adaptation.

Conclusions:

Tele-pharmacy needs to be considered alongside tele-consultations when providing healthcare to remote and rural communities. Technological solutions may provide a reliable and accessible option for providing access to urgently required medications.