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International Journal of Clinical Pharmacy

, Volume 37, Issue 5, pp 687–697 | Cite as

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

  • Inajara Rotta
  • Teresa M. Salgado
  • Maria Lara Silva
  • Cassyano J. Correr
  • Fernando Fernandez-LlimosEmail author
Review Article

Abstract

Background Multiple reviews have evaluated the impact of pharmacist-delivered patient care on health-related outcomes. However, it is unclear which of the pharmacist-delivered interventions in these services are the most effective. Aim of the review To gather the evidence of the impact of clinical pharmacy services on the medication use process or on patient outcomes using an overview of systematic reviews. Methods PubMed was searched to retrieve systematic reviews published between 2000 and 2010 that assessed the impact of clinical pharmacy services on the medication use process or patient outcomes. Two independent reviewers evaluated the study eligibility and one extracted the description and results of the services. The methodological quality of each review was assessed with the R-AMSTAR tool. Results Of the 343 potentially relevant records identified, 49 systematic reviews, comprising a total of 269 randomized controlled trials, met the selection criteria. Clinical pharmacy services that focused on specific medical conditions, such as hypertension or diabetes mellitus, revealed a positive impact of pharmacists’ interventions on patient outcomes. For other medical conditions, however, the results were inconclusive (e.g., dyslipidemia or thromboprophylaxis). Interventions that targeted medication adherence and assessed the impact of clinical pharmacy services in prescription appropriateness also produced inconclusive results because of the variability of methods used to assess both medication adherence and medication appropriateness. Conclusions Systematic reviews that assessed clinical pharmacy services targeting specific conditions were more conclusive given that the intervention was well defined, and the measured outcomes were unequivocal and tangible. Conversely, the results were inconclusive for interventions with a broader target and with monitoring parameters that were unclearly established or inconsistently assessed across studies. These findings emphasize the need to better define clinical pharmacy services and standardize methods that assess the impact of these services on patient health outcomes.

Keywords

Clinical pharmacy services Pharmaceutical care Pharmacists Systematic review 

Notes

Funding

Postgraduate Program in Pharmaceutical Sciences of the Federal University of Parana, Brazil and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—CAPES (Coordination for the Improvement of Highly Educated Personnel).

Conflicts of interest

None of the authors has any conflicts of interest to disclose that could affect the study results.

Supplementary material

11096_2015_137_MOESM1_ESM.docx (25 kb)
Supplementary material 1 (DOCX 25 kb)
11096_2015_137_MOESM2_ESM.docx (92 kb)
Supplementary material 2 (DOCX 93 kb)

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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015

Authors and Affiliations

  • Inajara Rotta
    • 1
  • Teresa M. Salgado
    • 2
  • Maria Lara Silva
    • 3
  • Cassyano J. Correr
    • 4
  • Fernando Fernandez-Llimos
    • 5
    Email author
  1. 1.Post-Graduate Program of Pharmaceutical SciencesFederal University of ParanaCuritibaBrazil
  2. 2.Research Institute for Medicines (iMed.ULisboa), Faculty of PharmacyUniversity of LisbonLisbonPortugal
  3. 3.Post-Graduate Program of Pharmaceutical CareFederal University of ParanaCuritibaBrazil
  4. 4.Department of PharmacyFederal University of ParanaCuritibaBrazil
  5. 5.Research Institute for Medicines (iMed.ULisboa) and Department of Social Pharmacy, Faculty of PharmacyUniversity of LisbonLisbonPortugal

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