Medication-related problems (MRPs) are common among older adults. The global population is ageing and there are health-related challenges linked to ageing in rural areas. Home-living rural older adults often face barriers to access healthcare, like long distances to healthcare services and poor continuity of care. Telepharmacy is the remote provision of pharmaceutical care, and telepharmacy could be of particular importance for rural older adults to improve their access to clinical pharmacy services and reduce the incidence of MRPs. The objective of this study is to develop and evaluate a novel telepharmacy service in primary care for home-living older adults in Northern Sweden’s rural areas. The primary objective is to evaluate the effect of the telepharmacy service regarding the identification, classification and resolution of MRPs.

This study will be conducted as a single-arm interventional study. A total of 100 people ≥65 years will receive the telepharmacy service for 12 weeks. The key principles of the telepharmacy service are to perform medication interviews and follow-up meetings with study participants, to conduct structured medication reviews, to conduct regular electronic medical record reviews and to have interprofessional collaboration with primary care physicians. All meetings will be conducted through video conferencing via a secure virtual care platform. Identified MRPs will be classified, and the acceptance rate of the pharmacists’ recommendations will be evaluated. The results will be presented with descriptive statistics. As secondary objectives, intra-individual changes in participants’ medication adherence, health-related quality of life and beliefs about medicines will be assessed through self-report questionnaires. Statistical analysis will be conducted using two-sided McNemar’s tests. Semi-structured interviews will also be conducted to explore participants’ and healthcare professionals’ experiences and attitudes towards this telepharmacy service.

This study has been granted ethical approval by the Swedish Ethical Review Authority (registration number 2022-03819-01 and 2024-08441-02). Participant informed consent is required. The results will be published in peer-reviewed journals and presented at scientific conferences.

NCT05629936.

The Swedish Prescribed Drugs and Health Cohort (SPREDH) is a population-based cohort based on merged data from four nationwide health data registers in Sweden. SPREDH provides opportunities to investigate how the use of various medications influences cancer risk, cancer prognosis and many other outcomes. The cohort was recently updated to include a longer follow-up, more patients and additional drugs.

SPREDH currently includes 9 454 340 users of selected medications, who have been followed up for a total of 138 015 003 person-years from 1 July 2005 to 31 December 2024, that is, for up to 191/2 years.

SPREDH includes data from the Swedish Prescribed Drug Register, Patient Register, Cancer Register and Cause of Death Register. Available data include participants’ characteristics, use of medication, healthcare utilisation, diagnoses (including detailed information on cancers), surgical procedures and dates and causes of death. The original version of SPREDH has been used for 10 original studies published in scientific journals, primarily in the fields of gastroenterology and oncology. The updated version of SPREDH includes 1 382 698 participants who have developed a cancer during the follow-up.

The newly updated and extended version of SPREDH enables studies with a wide range of study designs and hypotheses, especially pharmacoepidemiological studies evaluating how the use of certain medications affects the risk and prognosis of cancer and other diseases. It also allows for comparative research across classes of medications, as well as investigations of drug utilisation, safety and effectiveness.