Can we document the practice of dispensing? A systematic review

Abstract

SUMMARYWhat is known: Documentation is a process indicator utilized to evaluate quality clinical pharmacist services. In this framework, documentation of dispensing, besides supporting patient care, allows evaluation of the impact of counselling. Objective: To identify and assess studies of documentation by pharmacists in the dispensing process. Method: A systematic review was carried out according to the following steps: (i) identification of studies in the following databases: PubMed/Medline, Web of Science, Scopus and Lilacs, using the descriptors 'counselling', 'dispensing', 'community pharmacy services', 'pharmacies' and 'pharmacists' in different combinations; (ii) evaluation of studies, in which the title, abstract and full text of the studies, and the evaluation of the methodological quality of the selected studies were analysed. Results: In total, 26 articles met the specific criteria. Few studies addressed documentation as part of the dispensing working process (3), and 16 articles reported documentation using nonelectronic systems. The main variables documented were patient information, drug therapy problems and clinical interventions. Furthermore, 20 studies showed the effects of documentation in the dispensing process and 23 studies included statistical evidence. Eight articles met between 42% and 75% of the 28 items recommended by the STROBE initiative, and two articles met approximately 60% of the 36 items recommended by the CONSORT initiative.

Perceived barriers to the implementation of clinical pharmacy services in a metropolis in Northeast Brazil

“…Another barrier mentioned was the lack of an electronic health record (EHR). Several studies report the beneficial impact of EHRs on patient safety and efficiency, such as improvement in quality of care, prescribing safety, disease management, clinical documentation, work practice, preventive care, and in the volume of communication between pharmacists and the healthcare team [ 62 – 64 ]. There is the Brazilian National Electronic Health Record (e-SUS AB), a system that gathers all of the patient's health information and shares it with all members of the healthcare team.…”

Anticoagulation management services in community pharmacy: Feasibility of implementing a quality improvement programme through a practice-based research network

“…When using QIs, it is often impossible to distinguish between a deficient clinical practice and a lack of appropriate documentation in pharmacy records. The literature has reported challenged and limited clinical documentation of patient care in community pharmacy . Our results may also suggest that quality of clinical practices is deficient.…”

Does drug dispensing improve the health outcomes of patients attending community pharmacies? A systematic review

“…The results of this systematic review demonstrate the positive influence of drug dispensing on the health outcomes of patients attending community pharmacies. Studies that address drug dispensing usually assess the quality of the practice showing a non-systematized and undocumented process [ 26 , 30 , 58 ]. Several strategies have been proposed to qualify this service, such as the development of instruments to support the practice and training pharmacists and pharmacy teams [ 27 , 38 , 59 ].…”

“…In recent years, studies have reported the impact of different clinical pharmacy services on the health outcomes of patients, such as medication review [ 21 ], medication reconciliation [ 22 ], medication synchronization [ 23 ], and medication therapy management [ 24 , 25 ]. However, there is a lack of evidence for the impact of drug dispensing on health outcomes, and studies have mainly addressed certain aspects of this practice, such as the evaluation of the structure, process, and quality of the service [ 26 – 30 ]. Thus, high-quality studies are needed to evaluate the impact of drug dispensing on clinical, humanistic, and economic outcomes of patients.…”