• Ahmad Z Al Meslamani, Amira B Kassem, Noha A El-Bassiouny, and Osama Mohamed Ibrahim.
• College of Pharmacy, Al Ain University of Science and Technology, Abu Dhabi, UAE.
• Int. J. Clin. Pract. 2021 Oct 1; 75 (10): e14563.

Aims Of The StudyTo describe the experience of six hospitals in the management of COVID-19 patients in rural areas through an assessment of proportions, types and clinical outcomes of remote clinical interventions.MethodsThis was a prospective observational study conducted in six Egyptian hospitals over a period five months. An emergency response was implemented in each hospital in order to connect clinical pharmacists with COVID-19 patients living in rural areas. Pharmacists used phone calls and social media applications, such as WhatsApp® to conduct two types of interventions; (a) Proactive interventions and (b) outcome-based interventions. IBM SPSS V26 was used for data analysis.ResultsOf the 418 patients included, 351 (83.97%) recovered, 60 (14.35%) were hospitalised and 7 (1.67%) were deceased. Medication orders per patient, high-alert medications per patient and prescribing errors per patient were 5.82, 1.45 and 0.74, respectively. Telepharmacy teams conducted 3318 phone calls, 2116 WhatsApp® chats and 1128 interventions, of which 812 (71.92%) were process-based and 316 (27.98%) were outcome-based. Among these interventions, four significant determinants of improvement in clinical outcomes were found: substitution of a prescribed drug (Adjusted odds ratio [AOR] = 4.03; 95% confidence interval [CI], 2.54-5.87), adding a drug to the prescription (AOR = 3.15; 95% CI, 1.87-4.76), advice the patient to stop smoking (AOR = 3.53; 95% CI, 1.98-5.17) and cessation of drug therapy (AOR = 3.11; 95% CI, 1.25-4.55). The most common medications involved in drug-related interventions were Hydroxychloroquine, Azithromycin and Paracetamol.ConclusionOur findings demonstrate significant impact of the remote pharmacist interventions on both medicines use and clinical outcomes of COVID-19 patients in rural areas. Pharmacists in developing countries should be supported to implement remote clinical services to provide patients in rural places with optimal care.© 2021 John Wiley & Sons Ltd.

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