School of Pharmacy, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Edgbaston, Birmingham, UK.
Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, Istanbul, Türkiye.
Int J Clin Pharm. 2024 Feb;46(1):56-69. doi: 10.1007/s11096-023-01658-x. Epub 2023 Nov 22.
Guidelines for pharmacy practitioners regarding various clinical pharmacy activities have been published in a number of countries. There is a need to review the guidelines and identify the scope of activities covered as a prelude to developing internationally acceptable common guidelines.
To review the scope of clinical pharmacy guidelines and assess the extent to which these guidelines conform to quality standards as per the AGREE II instrument.
Medline, Embase, Guideline Central, International Pharmaceutical Abstracts, Google Scholar and Google (for grey literature) were searched for the period 2010 to January 2023. Guidelines which focused on any health care setting and any clinical pharmacy activity were included. Data were extracted and quality assessed independently by two reviewers using the English version of the AGREE II instrument.
Thirty-eight guidelines were included, mostly originating from Australia (n = 10), Ireland (n = 8), UK (n = 7) and USA (n = 5). Areas covered included medication reconciliation, medicines optimisation, medication management and transition of care. As per the AGREE II assessment, the highest score was obtained for the scope and purpose domain and the lowest score for rigour of development, mainly due to non-consideration of literature/evidence to inform guideline development.
Clinical pharmacy guidelines development processes need to focus on all quality domains and should take a systematic approach to guideline development. Guidelines need to further emphasise person-centred care and clinical communication. There is a scope to harmonise the guidelines internationally considering the diverse practices, standards and legislations across different geographies.
许多国家已经发布了针对药剂师的各种临床药学活动指南。有必要对这些指南进行审查,确定所涵盖的活动范围,作为制定国际认可的共同指南的前奏。
审查临床药学指南的范围,并评估这些指南在多大程度上符合 AGREE II 工具规定的质量标准。
使用 Medline、Embase、Guideline Central、International Pharmaceutical Abstracts、Google Scholar 和 Google(用于灰色文献)检索 2010 年至 2023 年 1 月期间的文献。纳入的指南聚焦于任何医疗保健环境和任何临床药学活动。使用 AGREE II 工具的英文版本,由两名评审员独立提取数据并进行质量评估。
共纳入 38 项指南,主要来自澳大利亚(n=10)、爱尔兰(n=8)、英国(n=7)和美国(n=5)。涵盖的领域包括用药核对、药物优化、药物管理和护理交接。根据 AGREE II 评估,范围和目的领域得分最高,而开发的严谨性得分最低,主要是因为没有考虑文献/证据来指导指南的制定。
临床药学指南制定过程需要关注所有质量领域,并采取系统的方法来制定指南。指南需要进一步强调以患者为中心的护理和临床沟通。考虑到不同地理位置的不同实践、标准和法规,有必要在国际上协调这些指南。