Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Pharmaceutical Care Services, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 376316, Riyadh, 11335, Kingdom of Saudi Arabia.
Syst Rev. 2018 May 2;7(1):71. doi: 10.1186/s13643-018-0727-4.
Pharmacist counselling is an important service that has been associated with improved outcomes. The primary aim of this review was to identify, describe, and determine the effectiveness of interventions for improving the counselling practice of community pharmacists.
We searched PubMed (from January 1990 to June 2017) and the Cochrane Library (June 2017). To supplement our database searches, we searched Google Scholar for papers that cited the identified studies. We included only studies that reported the impact of the intervention on pharmacists' behaviour during counselling. We searched for data from studies with randomised trials, non-randomised trials, controlled before-after studies, or interrupted time series study designs. Parameters including selection bias, performance bias, detection bias, and attrition bias were assessed. The data were narratively synthesised.
We screened 2335 abstracts and 59 full-text articles and included 17 RCTs. Overall, three studies were determined to have a high risk of bias, and 14 studies were determined to have an unclear risk of bias. Fifteen studies investigated multifaceted interventions that included two or more components. The most commonly used interventions were educational meetings (n = 14), educational materials (n = 9), educational outreach visits (n = 5), feedback (n = 5), guidelines (n = 5), and local opinion leaders (n = 2). Outcomes were measured using simulated patient visits (n = 10), and the self-reported outcomes of patient or pharmacists (n = 6). Most of the included studies (n = 11) reported some degree of improvement in counselling practices.
The included studies showed that educational meetings combined with educational materials, outreach visits, and feedback can improve pharmacist counselling in community settings. However, the unclear risk of bias and poor quality of reporting intervention components necessitate caution in interpreting the findings. Recommendations for future studies based on the evidence gap identified in this review are presented.
药剂师咨询是一项重要的服务，已被证明与改善结果有关。本研究的主要目的是确定、描述和评估干预措施，以提高社区药剂师的咨询实践。
我们检索了 PubMed（从 1990 年 1 月至 2017 年 6 月）和 Cochrane 图书馆（2017 年 6 月）。为了补充我们的数据库搜索，我们在 Google Scholar 上搜索了引用已确定研究的论文。我们仅纳入报告干预对药剂师咨询行为影响的研究。我们搜索了随机试验、非随机试验、对照前后研究或中断时间序列研究设计的数据。评估了选择偏倚、实施偏倚、检测偏倚和失访偏倚等参数。数据以叙述性方式综合。
我们筛选了 2335 篇摘要和 59 篇全文，并纳入了 17 项 RCT。总体而言，有 3 项研究被认为存在高偏倚风险，14 项研究存在不确定偏倚风险。15 项研究调查了包括两个或多个组成部分的多方面干预措施。最常用的干预措施是教育会议（n=14）、教育材料（n=9）、教育外展访问（n=5）、反馈（n=5）、指南（n=5）和当地意见领袖（n=2）。使用模拟患者就诊（n=10）和患者或药剂师的自我报告结果（n=6）来衡量结果。大多数纳入的研究（n=11）报告了咨询实践的某种程度的改善。
纳入的研究表明，教育会议结合教育材料、外展访问和反馈可以改善社区环境中的药剂师咨询。然而，由于干预措施组成部分的偏倚风险不明确和报告质量差，在解释研究结果时需要谨慎。根据本研究中确定的证据差距，提出了对未来研究的建议。
