Pharmacist-participated medication review in different practice settings: Service or intervention? An overview of systematic reviews

PLoS One. 2019 Jan 10;14(1):e0210312. doi: 10.1371/journal.pone.0210312. eCollection 2019.

Abstract

Introduction: Medication review (MR) is a pharmacy practice conducted in different settings that has a positive impact on patient health outcomes. In this context, systematic reviews on MR have restricted the assessment of this practice using criteria such as methodological quality, practice settings, and patient outcomes. Therefore, expanding research on this subject is necessary to facilitate the understanding of the effectiveness of MR and the comparison of its results.

Aim: To examine the panorama of systematic reviews on pharmacist-participated MR in different practice settings.

Methods: A literature search was undertaken in Biblioteca Virtual em Saúde (BVS), Embase, PubMed, Scopus, The Cochrane Library, and Web of Science databases through January 2018 using keywords for "medication review", "systematic review", and "pharmacist". Two independents investigators screened titles, abstracts, full texts; assessed methodological quality; and, extracted data from the included reviews.

Results: Seventeen systematic reviews were included, of which sixteen presented low to moderate methodological quality. Most of reviews were conducted in Europe (n = 7), included controlled primary studies (n = 16), elderly patients (n = 9), and long-term care facilities (n = 8). Seven reviews addressed MR as an intervention and thirteen reviews cited collaboration between physicians and pharmacists in the practice of MR. In addition, thirteen terminologies for MR were used and the main objective was to identify and solve drug-related problems and/or optimize the drug use (n = 11).

Conclusion: There is considerable heterogeneity in practice settings, population, definitions, terminologies, and approach of MR as well as poor description of patient care process in the systematic reviews. These facts may limit the comparison, summarization and understanding of the results of MR. Furthermore, the methodological quality of most systematic reviews was below ideal. Thus, international agreement on the MR process is necessary to assess, compare and optimize the quality of care provided.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Delivery of Health Care
  • Humans
  • Patient Care
  • Pharmaceutical Services
  • Pharmacies
  • Pharmacists*
  • Quality of Life
  • Systematic Reviews as Topic*
  • Treatment Outcome

Grants and funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.