Pharmacist services for non-hospitalised patients

Abstract

The results demonstrate that pharmacist services have varying effects on patient outcomes compared with usual care. We found no studies comparing services delivered by pharmacists with other healthcare professionals that evaluated the impact of the intervention on the six main outcome measures. The results need to be interpreted cautiously because there was major heterogeneity in study populations, types of interventions delivered and reported outcomes.There was considerable heterogeneity within many of the meta-analyses, as well as considerable variation in the risks of bias.

PaCIR: A tool to enhance pharmacist patient care intervention reporting

“…The highlighted flaw related to inconsistency in reporting closely reflects the major findings from 2 of the largest systematic reviews completed to date on pharmacist patient care services. 9,10 From these published systematic reviews of the pharmacy patient care intervention literature, key gaps in reporting were revealed. These include failure to adequately describe the components of the intervention (simply using the terms "MTM" or "pharmaceutical care" have been deemed to be insufficient).…”

“…These include failure to adequately describe the components of the intervention (simply using the terms "MTM" or "pharmaceutical care" have been deemed to be insufficient). [8][9][10] Further lacking are adequate descriptions of the intensity of intervention(s) as well as follow-up frequency, enrollment methods, degree of integration with standards of care, and reimbursement descriptors. Despite existing guidance, inadequate reporting of randomization mechanisms (when present), confounders, and attrition rates have also negatively affected pharmacist intervention publication acceptance by higher-order analyses, resulting in a vast majority of manuscripts being excluded.…”

“…Despite existing guidance, inadequate reporting of randomization mechanisms (when present), confounders, and attrition rates have also negatively affected pharmacist intervention publication acceptance by higher-order analyses, resulting in a vast majority of manuscripts being excluded. [8][9][10] For example, fewer than 11% (44/419) of individual studies pertaining to pharmacist patient care interventions evidence were considered to be sufficiently descriptive for inclusion in a 2014 systematic review and meta-analysis. 8 A specific tool for reporting pharmacist patient care interventions, a manuscript checklist with interpretative guidance, is needed based on deliberate examination of the existing pharmacist patient care interventions body of literature, the conclusions of multiple systematic reviews and metaanalyses of that evidence, available manuscript publication guidance tools, and discussion with a multitude of pharmacy profession stakeholders and pharmacy and medical journal editors, including an expert advisory panel convened by the American Pharmacists Association.…”

The change in pharmacists’ attitude, confidence and job satisfaction following participation in a novel hypertension support service

“…Particularly, there has been evidence for the effects of providing support for lifestyle disease patients, and there have been many studies demonstrating the effectiveness of pharmacists and physicians collaborating as a medical team to provide treatment, and verifying the effects of pharmacists’ support on blood pressure control . A review summarized in 2018 showed that pharmacist services may reduce the percentage of patients whose blood pressure is outside the target range, and it can therefore also be said that providing support for lifestyle disease patients is another important role for pharmacists. In Japan as well, in addition to safely providing drug treatment, pharmacies have recently been expected to support patients’ health…”

The evolution of pharmacy practice research–Part I: Time to implement the evidence†

“…Underlining the direction of the change has been evidence derived from research studies confirming that the care provided by pharmacists is generally equivalent to and sometimes better than usual care. A recently published Cochrane review concluded that ‘Some services provided by pharmacists can have positive effects on patient health, including improved management of blood pressure and physical function’ whilst emphasising the challenges from the heterogeneity of the identified studies and risk of bias in some . Similarly another Cochrane review focusing solely on hypertension concluded that ‘pharmacist led care may be a promising way of improving control in patients with hypertension, with the majority of RCTs being associated with improved blood pressure control, improved systolic blood pressure and more modestly improved diastolic blood pressure, but these interventions require further evaluation’ .…”