Community pharmacy services (CPS) have been shown to be positive in many disease management and patient care programs, but clinical outcomes were followed by process indicators and methodological flaws in previous researches made it difficult to prove the effectiveness of clinical outcomes of CPS. Therefore, this study attempted to review the clinical outcomes of CPS. Interventions included are provision of medication review, patient education, adherence assessment, health/lifestyle advice, physical assessment, monitoring, prescribing, or adjusting and administering therapy from community pharmacists. By searching for key words like community pharmacists, pharmaceutical services, clinical outcomes in MEDLINE and EMBASE and manually searching (up to June 2017), 1910 studies investigating the clinical outcomes of CPS were obtained. After screening the titles, abstracts and full texts for relevancy, 52 researches with controlled groups were included and assessed for methodological quality. Finally, 25 studies were selected for the meta‐analysis based on their common endpoints: systolic blood pressure, diastolic blood pressure and glycosylated haemoglobin. The Cochrane tool was used to assess the risk of bias. Chi‐square and I‐square tests were performed to assess heterogeneity, and the weighted mean differences were estimated using random effect models. Of the 52 articles, 47 studies demonstrated that CPS had positive clinical outcomes, 3 studies showed mixed outcomes and 2 studies revealed no effects. In the meta‐analysis, intervention groups displayed greater reductions in systolic BP (95% CI: −8.198–2.356), diastolic BP (95% CI: −3.648–0.645) and HbA1c (95% CI: −0.905–0.224) than usual care groups. CPS have positive clinical outcomes, particularly significant reductions in systolic BP, diastolic BP and HbA1c. It was difficult to find out which intervention(s) of CPS directly led to certain changes and influence of CPS might be underestimated for only three common surrogate endpoints. More researches should be conducted with sufficient data.

BackgroundClinical pharmacy is not only a medical science but also an elaborate public health care system firmly related to its subsystems of education, training, qualification authentication, scientific research, management, and human resources. China is a developing country with a tremendous need for improvements in the public health system, including the clinical pharmacy service system.ObjectivesThe aim of this research was to evaluate the infrastructure and personnel qualities of clinical pharmacy services in China.SettingPublic county hospitals in China.Materials and methodA national survey of clinical pharmacists in county hospitals was conducted. It was sampled through a stratified sampling strategy. Responses were analyzed using descriptive and inferential statistics. The main outcome measures include the coverage of clinical pharmacy services, the overall staffing of clinical pharmacists, the software and hardware of clinical pharmacy services, the charge mode of clinical pharmacy services, and the educational background, professional training acquisition, practical experience, and entry path of clinical pharmacists.ResultsThe overall coverage of clinical pharmacy services on both the department scale (median = 18.25%) and the patient scale (median = 15.38%) does not meet the 100% coverage that is required by the government. In 57.73% of the sample hospitals, the staffing does not meet the requirement, and the size of the clinical pharmacist group is smaller in larger hospitals. In addition, 23.4% of the sample hospitals do not have management rules for the clinical pharmacists, and 43.1% do not have rational drug use software, both of which are required by the government. In terms of fees, 89.9% of the sample hospitals do not charge for the services. With regard to education, 8.5% of respondents are with unqualified degree, and among respondents with qualified degree, 37.31% are unqualified in the major; 43% of respondents lack the clinical pharmacist training required by the government. Most respondents (93.5%) have a primary or medium professional title. The median age and work seniority of respondents are 31 and four years, respectively. Only 18.5% of respondents chose this occupation by personal consideration or willingness.ConclusionsThe main findings in this research include the overall low coverage of clinical pharmacy services, the low rate of clinical pharmacy service software, hardware, and personnel as well as a wide variance in educational training of pharmacists at county hospitals.

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Objective: Occupational stress of health care providers may lower the quality of care. Personenvironment fit theory and practical evidence have indicated that various types of knowledge and skills of health care providers are differentially associated with occupational stress. Clinical pharmacists are an indispensable part of medical teams. Clinical pharmacists in China are generally under high occupational stress, but what kind of knowledge and skills can relieve their occupational stress remains unclear. This study aimed to assess the association between the specific knowledge and skills of clinical pharmacists and their occupational stress in China. This study aimed to assess the association between the specific knowledge and skills of clinical pharmacists and their occupational stress in China. Methods: A field questionnaire survey using a stratified sampling was conducted to gather data on occupational stress, knowledge and skills related to hospital pharmacy, and other factors of occupational stress using the Brief Job Stress Questionnaire and a self-developed instrument. Ordinary least squares regression was used to evaluate the association of the participants' knowledge, skills, and other factors with their occupational stress. Results: A total of 625 clinical pharmacists from 311 tertiary hospitals in China (response rate ¼ 84%) participated. Knowledge of or skills related to pharmaceutical care service provision (P ¼ 0.02), the use of computers and the Internet in pharmacy practice (P ¼ 0.02), interpersonal communication (P ¼ 0.10), or pharmacoepidemiology (P ¼ 0.08) was associated with reduced occupational stress of the participants. Participants who had credentials of nation-level specialized (P ¼ 0.09) and general training (P ¼ 0.04) for clinical pharmacist had lower degrees of occupational stress than those without these credentials. The participants' clinical professions, routine tasks, technical titles, and type of hospital they work in were also associated with their occupational stress. Conclusion: Enhancing several aspects of knowledge or skills among clinical pharmacists in tertiary hospitals in China may help reduce their occupational stress. Efforts are needed to improve the education and training system of clinical pharmacists in China.