The urge for specific standards of telepharmacy services: Lessons learned from qualitative study in Indonesian community pharmacies

Objective: Like many low- and middle-income countries, Indonesia lacks specific standards for telepharmacy practices, which requires adherence to traditional pharmacy guidelines to evaluate the services. This study aims to explore the disparities between the implementation of telepharmacy services in community pharmacies and the established Indonesian pharmaceutical service standards. Methods: This qualitative study was conducted in seven community pharmacies in Depok, an urban area near Jakarta. Data were collected in 2023 using triangulation methods: semi-structured interviews, direct observations, and simulated patient interactions. Verbatim transcriptions and thematic analysis were performed using NVivo®12 to analyse the findings. Results: Four identified themes were the structures, daily practices, challenges, and enablers of telepharmacy services. The scope of telepharmacy services consisted of dispensing medicines, patient education, and providing drug information through mobile applications by pharmacy electronic system organisers (PSEF) or social media platforms. Challenges in daily practice revealed gaps in traditional pharmaceutical service guidelines, including systems interoperability, effective communication among pharmacists-physician-patients, and the need for standards specific to digital pharmaceutical services. Common problems in telepharmacy were uncertain medicine availability, unclear e-prescription validity, limited pharmacist-physician collaboration, and impeded patient education, particularly in services provided through PSEF applications. On the other hand, the availability of digital technologies was seen as beneficial, highlighting the necessity for predefined standardised facilities to ensure the quality of telepharmacy services. Conclusion: While traditional pharmaceutical service standards can be applied to evaluate telepharmacy practices, specific challenges must be explicitly addressed within a dedicated telepharmacy standard to ensure patient safety and service quality.