Abstract
Telepharmacy is increasingly recognized as a transformative model for improving access to pharmaceutical care, enhancing and supporting chronic disease management through remotely delivered medication review, therapy optimization, and adherence support. By enabling structured pharmacist-led interventions, telepharmacy has the potential to enhance medication safety by reducing prescribing errors, improving monitoring of high-risk therapies, and strengthening continuity of care across healthcare settings. Saudi Arabia has rapidly expanded digital health initiatives under Vision 2030, yet its telepharmacy landscape remains in an evolving developmental stage compared with mature systems in the United States of America (USA) and the United Kingdom (UK). This narrative review examines the enabling and limiting factors influencing telepharmacy implementation for chronic disease management across these three regions, with a focus on digital infrastructure, clinical outcomes, regulatory preparedness, pharmacist readiness, and patient experience. Saudi Arabia demonstrates early clinical success and features advanced institutional models. However, persistent challenges include regulatory ambiguity, inconsistent enforcement, limited pharmacist training, digital literacy gaps, and a shortage of rigorous outcome-based research. Insights from the USA and UK emphasize the importance of national governance, sustainable reimbursement models, and standardized workflows. Strengthening regulation, enhancing workforce training, and establishing financial sustainability are critical for advancing telepharmacy within Saudi Arabia's chronic disease management pathways.