The number of intervention studies designed to improve quality of care is increasing exponentially, making it difficult to access all available information on a given subject. Systematic reviews are tools that provide health professionals with comprehensive and objective information. This article describes the main phases of a systematic review: formulating the research question, search and selection of studies, data extraction and analysis, assessment of the methodological quality of studies, and synthesis of the results. Interventions designed to improve professional practices and organisation of care have specific characteristics that determine the methodology of systematic reviews. For example, the often substantial heterogeneity between populations, organisations, and intervention settings among studies must be taken into account, which makes meta-analysis more difficult. Knowledge on specific features of systematic reviews designed to improve quality of care is essential to ensure a good review of the literature, or to evaluate the level of evidence of published systematic reviews.

Cancer chemotherapy is a high-risk process. To improve patient safety, a systematic pharmaceutical analysis of chemotherapy prescriptions is performed in our institution. The aim of this study was to assess the impact of pharmaceutical interventions (PIs) on the safety of patient chemotherapy prescriptions. Methods: This prospective cross-sectional study was conducted in an 800-bed university hospital with oncology departments. All chemotherapy prescriptions were included and PIs were collected prospectively during one month. The clinical impact of PIs was scored by an expert panel of oncologists and pharmacists, using the Hatoum scale. Univariate and multivariate analysis were conducted to identify factors associated with a higher frequency of PIs. Results: Of 1346 prescriptions included, 129 required a PI (9.6% (95% CI: 8.1-11.4)). Most PIs were scored as having at least a significant impact for patient safety (69.8% (95% CI: 60.4-76.9)). The frequency of PIs was significantly associated with tumour site (p ¼ 0.04) and weekday of prescription (p ¼ 0.005). Multivariate analysis identified factors independently associated with PI performance, including pancreas and biliary tract cancers (odds ratio ¼ 2.8 (95% CI: 1.4-5.3)), ovary cancers (odds ratio ¼ 2.4 (95% CI: 1.2-4.8)) and head and neck cancers (odds ratio ¼ 2.4 (95% CI: 1.1-5.1)) and the day 1 of the protocol with a cytotoxic agent (odds ratio ¼ 3.7 (95% CI: 1.1-11.1)). Conclusions: Oncology pharmacists have a critical role in the safety of chemotherapy prescriptions. The coordination between healthcare professionals and access to patient data seem essential to improve the PIs' relevance and their clinical impact on patient safety.

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