Effectiveness of clinical pharmacy services: an overview of systematic reviews (2000–2010)

Rotta, Inajara; Salgado, Teresa M.; Silva, Maria Lara; Correr, Cassyano Januário; Fernández-Llimós, Fernando

doi:10.1007/s11096-015-0137-9

Cited by 113 publications

(92 citation statements)

References 80 publications

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“…Pharmacist roles are dynamic and have evolved from providing patient support on medication use to being a clinical decision‐making team member across a range of specializations. Indeed, the role of pharmacists in providing a high level of patient care in DSM that improves patient outcomes and saves the health care system money has been well documented . In the present investigation we found that WV pharmacists generally have ambivalent attitudes toward DSM, regardless of their gender, CDE status, graduation institution type, or number of years in practice.…”

Section: Discussionsupporting

confidence: 89%

“…Indeed, the role of pharmacists in providing a high level of patient care in DSM that improves patient outcomes and saves the health care system money has been well documented. 18,20,25 In the present investigation we found that WV pharmacists generally have ambivalent attitudes toward DSM, regardless of their gender, CDE status, graduation institution type, or number of years in practice. Despite this, the majority of WV pharmacists and their employers have shown interest in understanding DSM by encouraging pharmacists to actively engage in continuing education programs that solidify their clinical knowledge.…”

Section: Discussionsupporting

confidence: 44%

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A qualitative assessment of West Virginia pharmacist activities and attitude in diabetes management

Shatnawi

Latif

2016

Evaluation Clinical Practice

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 44%

A qualitative assessment of West Virginia pharmacist activities and attitude in diabetes management

Shatnawi

Latif

2016

Evaluation Clinical Practice

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“…In several countries professional pharmacy services are being remunerated and pharmacies are beginning to implement, however the implementation process pharmacies are undergoing is largely unknown [10]. Pharmacy practice research remains predominantly focused on clinical and cost effectiveness of the professional services [11], barriers and facilitators [12–15], pharmacy culture [16], perception of pharmacy [10, 17], and remuneration [18, 19]. …”

Section: Introductionmentioning

confidence: 99%

Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis

Moullin

Sabater‐Hernández

Benrimoj

2016

BMC Health Serv Res

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BackgroundMultiple studies have explored the implementation process and influences, however it appears there is no study investigating these influences across the stages of implementation. Community pharmacy is attempting to implement professional services (pharmaceutical care and other health services). The use of implementation theory may assist the achievement of widespread provision, support and integration. The objective was to investigate professional service implementation in community pharmacy to contextualise and advance the concepts of a generic implementation framework previously published.MethodsPurposeful sampling was used to investigate implementation across a range of levels of implementation in community pharmacies in Australia. Twenty-five semi-structured interviews were conducted and analysed using a framework methodology. Data was charted using implementation stages as overarching themes and each stage was thematically analysed, to investigate the implementation process, the influences and their relationships. Secondary analyses were performed of the factors (barriers and facilitators) using an adapted version of the Consolidated Framework for Implementation Research (CFIR), and implementation strategies and interventions, using the Expert Recommendations for Implementing Change (ERIC) discrete implementation strategy compilation.ResultsSix stages emerged, labelled as development or discovery, exploration, preparation, testing, operation and sustainability. Within the stages, a range of implementation activities/steps and five overarching influences (pharmacys' direction and impetus, internal communication, staffing, community fit and support) were identified. The stages and activities were not applied strictly in a linear fashion. There was a trend towards the greater the number of activities considered, the greater the apparent integration into the pharmacy organization. Implementation factors varied over the implementation stages, and additional factors were added to the CFIR list and definitions modified/contextualised for pharmacy. Implementation strategies employed by pharmacies varied widely. Evaluations were lacking.ConclusionsThe process of implementation and five overarching influences of professional services implementation in community pharmacy have been outlined. Framework analysis revealed, outside of the five overarching influences, factors influencing implementation varied across the implementation stages. It is proposed at each stage, for each domain, the factors, strategies and evaluations should be considered. The Framework for the Implementation of Services in Pharmacy incorporates the contextualisation of implementation science for pharmacy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1689-7) contains supplementary material, which is available to authorized users.

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“…Broad and unclear monitoring targets lead to inconclusive evidence in the evaluation of the impact of CP services. More conclusive evidence for the effectiveness of CP services are reported when the interventions are rigorously defined, in specific medical conditions, and when there are unequivocal outcomes 23. Often, pharmacists are sole practitioners when providing specialist services, which makes unpicking and measuring their individual clinical contributions relatively straightforward.…”

Section: Introductionmentioning

confidence: 99%

Evidence for the outcomes and impact of clinical pharmacy: context of UK hospital pharmacy practice

et al. 2017

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Objectives: The role of clinical pharmacists in hospitals has evolved and continues to expand.In the UK, outside a few national policy drivers, there are no agreed priorities, measures or defined outcomes for hospital clinical pharmacy (CP). This paper aims to 1) highlight the need to identify and prioritise specific clinical pharmacy roles, responsibilities and practices that will bring the greatest benefit to patients and health-systems and 2) describe systemic weaknesses in current research methodologies for evaluating clinical pharmacy services and propose a different approach Method: Published reviews of CP services are discussed using the economic, clinical and humanistic outcomes (ECHO) framework. Recurring themes regarding study methodologies, measurements and outcomes are used to highlight current weaknesses in studies evaluating CP.Results: Published studies aiming to demonstrate the economic, clinical or humanistic outcomes of clinical pharmacy often suffer from poor research design and inconsistencies in interventions, measurements and outcomes. This has caused difficulties in drawing meaningful conclusions regarding clinical pharmacy's definitive contribution to patient outcomes.Conclusion: There is a need for more research work in NHS hospitals, employing a different paradigm to address some of the weaknesses of existing research on clinical pharmacy practice. We propose a mixed-methods approach, including qualitative research designs, and with emphasis on cost-consequence analyses for economic evaluations. This approach will provide more meaningful data to inform policy and demonstrate the contribution of hospital clinical pharmacy activities to patient care and the NHS. 4 Key MessagesWhat is already known on this subject• Clinical Pharmacy is a diverse, complex discipline and clinical pharmacy activities are not easily defined or described • It is important to robustly show the benefits of clinical pharmacy, in order to justify resource use and to prioritise and measure activities • Studies purporting to demonstrate the outcomes of clinical pharmacy activities are often criticized due to methodological flaws, poor intervention descriptions and weak conclusionsWhat this study adds• The current positivist mindset is weakening the case for clinical pharmacy. There is a need for a new research approach for studying and evaluating clinical pharmacy interventions • Mixed-methods studies, incorporating quantitative and qualitative methodologies are more appropriate for evaluating the outcomes of clinical pharmacy • Cost-consequence analyses are more suitable for evaluating the economic outcomes of clinical pharmacy 5

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Effectiveness of clinical pharmacy services: an overview of systematic reviews (2000–2010)

Cited by 113 publications

References 80 publications

A qualitative assessment of West Virginia pharmacist activities and attitude in diabetes management

A qualitative assessment of West Virginia pharmacist activities and attitude in diabetes management

Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis

Evidence for the outcomes and impact of clinical pharmacy: context of UK hospital pharmacy practice

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