Impact of Telepharmacy on Glycemic Control in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

Abstract

Background:

Pharmacists play a vital role in optimizing therapy and supporting glycemic control in patients with type 2 diabetes (T2D). Telepharmacy extends these services remotely. However, previous meta-analyses often combined telepharmacy with other interventions, limiting the clarity of their conclusions. This study aimed to evaluate the effect of telepharmacy on glycemic control in patients with T2D.

Methods:

PubMed, Cochrane Library, Embase, CINAHL, and EBSCO Open Dissertations were searched from inception to March 2026. Randomized controlled trials (RCTs) investigating the effect of telepharmacy in patients with T2D and reporting glycated hemoglobin (HbA1c) outcomes were included. Study quality was assessed using the Risk of Bias (RoB) 2 tool. The mean difference (MD) in HbA1c with 95% confidence intervals (CI) was pooled using a random-effects model. Heterogeneity was assessed using the I² statistic. The certainty of the evidence was evaluated using the GRADE approach. PROSPERO (CRD420251105397).

Results:

Three RCTs (487 participants) were included. Telepharmacy interventions shared similar contexts, focusing on adherence improvement, lifestyle improvement, and diabetes education. Telepharmacy was associated with a statistically significant reduction in HbA1c compared with usual care (MD –0.64; 95% CI –0.93 to –0.35) with no heterogeneity observed (I² = 0%). All trials were rated as having “some concerns” in RoB. The certainty of the evidence was rated as low due to RoB and imprecision.

Conclusions:

Telepharmacy significantly improved glycemic control in patients with T2D. It may be considered a supportive strategy to enhance access to care and promote patient self-management, particularly among individuals facing barriers to health care access.