Santana Elizabete Priscila Costa, Javarini Haidelucia Rodrigues Vieira, de Araújo Dyego Carlos Souza Anacleto, Cerqueira-Santos Sabrina, Reis Tiago Marques, Dos Santos-Junior Genival Araujo, Rocha Kérilin Stancine Santos
Laboratory of Innovation for Healthcare (Linc), Postgraduate Program in Pharmaceutical Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil.
Research Group on Implementation of Clinical Pharmacy Services in Brazilian Health System (SUS). Postgraduate Program in Pharmaceutical Assistance (PPGASFAR), Federal University of Espírito Santo, Vitória, ES, Brazil.
BMC Health Serv Res. 2025 Jan 29;25(1):172. doi: 10.1186/s12913-024-12074-w.
Inadequate medication knowledge and medication nonadherence by patients are considered an issue in healthcare, as they can lead to negative outcomes, such as therapeutic failures and hospitalization. Even though drug dispensing, which has pharmacist counseling as a core element, is a service traditionally performed by pharmacists, there is still no evidence about the influence of this service on these health outcomes.
To evaluate the influence of drug dispensing on patients' medication knowledge and medication adherence.
A systematic review was conducted in which a literature search was performed in the PubMed/Medline, Biblioteca Virtual da Saúde, Web of Science, and Embase databases, as well as in gray literature. Two reviewers read the titles, abstracts and complete texts according to the eligibility criteria and extracted the data from the included articles. Original studies-of any design-evaluating the influence of drug dispensing on patients' medication knowledge and/or adherence in community pharmacies were included. The methodological quality was assessed through the tools provided by the JBI Institute. The data was analyzed through qualitative synthesis and a meta-analysis was conducted for randomized controlled trials which used the outcome of medication adherence using the RStudio version 4.3.3 program.
A total of 7,590 studies were identified in the initial search, of which 11 articles met the eligibility criteria and were included in this systematic review. The studies were published in Africa, Latin America, Asia, Europe and Australia. Most of the studies were interventional (n = 7). Four studies evaluated the influence of drug dispensing on the patient's medication knowledge, and all showed that knowledge increased after dispensing. Eight studies evaluated the influence of dispensing on medication adherence. Three studies were included in the meta-analysis, which showed moderate heterogeneity (I = 44%, p = 0.17). The results indicated that there was no statistically significant difference in medication adherence post-dispensing (RR: 1.19; 95%CI 0.99 to 1.43, p = 0.07). Six studies met more than 70% of the quality assessment criteria.
This systematic review demonstrated that patient's medication knowledge can be increased through drug dispensing. However, the meta-analysis indicated that drug dispensing does not have an impact on medication adherence. Our findings can support evidence-based decisions, guiding the planning and development of public policies and interventions which improve drug dispensing for patients, families, and communities.
患者用药知识不足和不遵医嘱被视为医疗保健中的一个问题，因为它们可能导致负面结果，如治疗失败和住院。尽管以药师咨询为核心要素的药品调配是药师传统上提供的一项服务，但仍没有证据表明这项服务对这些健康结果有何影响。
评估药品调配对患者用药知识和用药依从性的影响。
进行了一项系统评价，在PubMed/Medline、虚拟健康图书馆、科学网和Embase数据库以及灰色文献中进行文献检索。两名评审员根据纳入标准阅读标题、摘要和全文，并从纳入的文章中提取数据。纳入任何设计的原始研究，以评估社区药房中药品调配对患者用药知识和/或依从性的影响。通过JBI研究所提供的工具评估方法学质量。通过定性综合分析数据，并使用RStudio 4.3.3版本程序对使用用药依从性结果的随机对照试验进行荟萃分析。
在初步检索中总共识别出7590项研究，其中11篇文章符合纳入标准并被纳入本系统评价。这些研究发表于非洲、拉丁美洲、亚洲、欧洲和澳大利亚。大多数研究为干预性研究（n = 7）。四项研究评估了药品调配对患者用药知识的影响，所有研究均表明调配后知识有所增加。八项研究评估了调配对用药依从性的影响。三项研究被纳入荟萃分析，结果显示存在中度异质性（I = 44%，p = 0.17）。结果表明，调配后用药依从性没有统计学上的显著差异（RR：1.19；95%CI 0.99至1.43，p = 0.07）。六项研究符合超过70%的质量评估标准。
本系统评价表明，通过药品调配可以增加患者的用药知识。然而，荟萃分析表明药品调配对用药依从性没有影响。我们的研究结果可为循证决策提供支持，指导公共政策和干预措施的规划与制定，以改善为患者、家庭和社区提供的药品调配服务。
