Determinants of telepharmacy acceptance and medication adherence among hemodialysis patients (TEAM-HD): a cross-sectional study from Indonesia and Malaysia

The socioeconomic burden of end-stage kidney disease (ESKD) in Malaysia and Indonesia necessitates innovative care strategies. The TEAM-HD study assessed medication adherence and telepharmacy acceptance among hemodialysis patients in Selangor (Malaysia) and South Sulawesi (Indonesia). From April 2023 to April 2024, 131 patients (Malaysia: 71; Indonesia: 60), aged ≥ 18 years and undergoing long-term hemodialysis, completed a validated questionnaire on demographics, dialysis and medication-related factors, and telepharmacy acceptance. Acceptance of telepharmacy was moderate in both cohorts (Malaysia: 64.8%; Indonesia: 62.0%). In Malaysia, Chinese (adjusted odds ratio [aOR] 0.15) and Indian (aOR 0.18) patients were significantly less likely than Malays to accept telepharmacy. In Indonesia, younger age and higher household income were significantly associated with higher telepharmacy acceptance. High medication adherence was observed in both settings but was not associated with telepharmacy acceptance. These findings support implementing patient-centered, opt-in telepharmacy models and warrant cost-effectiveness evaluation in resource-constrained dialysis settings.