Rotta Inajara, Souza Thais Teles, Salgado Teresa M, Correr Cassyano J, Fernandez-Llimos Fernando
Post-Graduate Program of Pharmaceutical Sciences, Federal University of Parana, Av. Prof. Lothário Meissner, 652, Jardim Botânico, 80210-170 Curitiba, Paraná, Brazil.
Department of Clinical Pharmacy, University of Michigan College of Pharmacy, 428 Church St, 48109 Ann Arbor, MI, USA.
Res Social Adm Pharm. 2017 Jan-Feb;13(1):201-208. doi: 10.1016/j.sapharm.2016.01.003. Epub 2016 Jan 14.
A critical analysis of the research on clinical pharmacy services with regards to study characteristics has not been undertaken since 1998. However, several meta-analyses have been conducted to demonstrate the impact of pharmacists' interventions in specific medical conditions. These meta-analyses present high heterogeneity in part because the interventions are poorly and inconsistently described in primary studies. The aim of this article is to present the characteristics of randomized control trials (RCTs) that assess clinical pharmacy services to identify areas of improvement in future pharmacy practice research studies. Different emphasis of research across geographic regions of the world were also examined. During these 40 years, 520 articles reporting 439 RCTs assessing clinical pharmacy services were published. Of the 439 studies, 77.7% (n = 341) were published in the year 2000 or thereafter, 41.46% (n = 182) were conducted in the US, 27.56% (n = 121) in Europe, and 30.98% (n = 136) in the rest of the world. Studies in pharmacy practice have improved in terms of design, with an increase in the number of published RCTs after 2000. However, the small sample size of RCTs is still an issue. After 2000, a significantly higher proportion of studies were conducted in community pharmacy, targeting specific medical conditions, and with a higher number of patients randomized to the intervention group. Conversely, a significantly smaller proportion of studies were conducted in the hospital and targeted a single recipient after 2000. Studies conducted in the US had significantly more intervention arms, focused mostly on a specific medical condition, and were performed in primary care. Different health care systems' organization and policies may influence clinical pharmacy services research across countries.
自1998年以来,尚未对临床药学服务研究的特征进行批判性分析。然而,已经进行了几项荟萃分析,以证明药师干预在特定医疗状况中的影响。这些荟萃分析存在高度异质性,部分原因是在原始研究中对干预措施的描述不佳且不一致。本文的目的是介绍评估临床药学服务的随机对照试验(RCT)的特征,以确定未来药学实践研究中需要改进的领域。还研究了世界不同地理区域研究的不同侧重点。在这40年中,发表了520篇报告439项评估临床药学服务的RCT的文章。在这439项研究中,77.7%(n = 341)于2000年或之后发表,41.46%(n = 182)在美国进行,27.56%(n = 121)在欧洲进行,30.98%(n = 136)在世界其他地区进行。药学实践研究在设计方面有所改进,2000年后发表的RCT数量有所增加。然而,RCT的样本量小仍然是一个问题。2000年后,在社区药房进行的研究比例显著更高,针对特定医疗状况,随机分配到干预组的患者数量更多。相反,2000年后在医院进行的研究比例显著更小,且针对单一接受者。在美国进行的研究有显著更多的干预组别,主要侧重于特定医疗状况,并且在初级保健中进行。不同的医疗保健系统组织和政策可能会影响各国的临床药学服务研究。