Does telepharmacy (remote pharmacy care) work better than usual care for people with long-term health conditions who are not in hospital?

Key messages

• Telepharmacy may help people take their medicines as prescribed, and may reduce both systolic blood pressure (the pressure in your arteries when your heart beats) and diastolic blood pressure (the pressure between heartbeats). It probably makes little or no difference to blood sugar control (HbA1c).

• We are very uncertain about its effects on patients’ satisfaction with care. Telepharmacy may affect medicine‐related problems (such as side effects or interactions), but findings varied because some interventions aimed to detect more problems while others aimed to reduce harms from medicines. No studies reported the number of deaths or unwanted effects from telepharmacy, so potential harms remain uncertain.

• Studies did not show consistent effects on quality of life, hospital admissions, hospital emergency department visits, or healthcare costs. Most studies involved only a few people or had limitations, and the studies varied in delivery and content.

What is telepharmacy?

Telepharmacy is the use of phone calls, video calls, mobile apps, or other electronic communication to provide pharmacy services without meeting in person. It can include advice about medicines, help with taking medicines as prescribed, and monitoring of health. Telepharmacy can make it easier for people to get support from a pharmacist, especially if they live far from a clinic or have difficulty travelling. It may also help pharmacists detect medicine‐related problems and adjust treatments when needed.

What are long-term health conditions?

Long-term health conditions, sometimes called chronic conditions, are health problems that can usually be controlled but not cured. They last for three months or longer, and may get worse over time. People with long-term conditions often require ongoing care. Examples include diabetes, high blood pressure, asthma, and heart disease. These conditions can affect a person’s quality of life and may lead to serious complications if not well managed. People with long‐term conditions often need regular check‐ups, tests, and support to take their medicines correctly.

What did we want to find out?

We wanted to find out whether telepharmacy, compared with usual care, helps people take their medicines as prescribed, and improves patients’ satisfaction with care, medicine‐related problems, asthma control, blood pressure, and blood sugar control (measured using the HbA1c test) in people with long‐term conditions in outpatient settings. We also looked at other possible effects, such as quality of life, admissions to hospital, emergency department visits, and healthcare costs.

What did we do?

We searched for studies that compared pharmacist‐led telepharmacy with usual care for people with long-term conditions in outpatient settings. We included high-quality studies, known as randomised controlled trials. We summarised the results and rated our confidence in the evidence, considering factors such as study design, number of participants, and consistency of results.

What did we find?

We found 21 trials including 5440 people, which were performed in different countries and settings (e.g. pharmacy, hospital). Most trials compared telepharmacy with usual face-to-face care for people with long‐term conditions in outpatient settings. In the included studies, usual care generally referred to standard face-to-face care without additional telepharmacy support. Most studies lasted 12 months or less.

In people with long-term conditions in outpatient settings, compared with usual care:

• telepharmacy may improve how well people take their medicines as prescribed (10 studies, 2978 people), that is, as instructed by their healthcare providers;

• the evidence is very uncertain about whether telepharmacy improves patients’ satisfaction with their care (3 studies, 422 people);

• telepharmacy may affect problems such as medicine side effects or interactions (5 studies, 547 people), but findings varied because some studies aimed to detect more problems while other studies aimed to reduce harms;

• telepharmacy may reduce systolic blood pressure (the pressure in your arteries when your heart beats) and diastolic blood pressure (the pressure between heartbeats) (5 studies, 1254 people); but

• telepharmacy probably makes little or no difference to blood sugar control (HbA1c levels) (5 studies, 1771 people).

No studies reported the number of deaths or unwanted effects from telepharmacy, so potential harms remain uncertain. We have more confidence in some findings (such as blood sugar control) than in others (such as patients' satisfaction with their care). For some outcomes, future research could change what we know.

What are the limitations of the evidence?

Our confidence in the findings was reduced because many studies involved only a few people, had problems with how they were carried out, or produced results that did not always agree. Evidence about problems caused by medicines came only from descriptions given by patients, as we were unable to group and analyse data from different studies. The studies used telepharmacy interventions that varied in their content, and how or how often they were given, which may have influenced the results.

How up to date is this evidence?

The evidence is up to date to December 2025.