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Intervention

Organisational Intervention: Revision of professional roles - pharmacy

Definition

The expansion of pharmacist roles to include new tasks

Effectiveness

Seven high quality reviews (Alldred, Buckley, Lemmens, Machado, Nkansah, Patterson, Royal) and one key review (Davey) were identified. Findings from one high quality review (Gould) indicate that this intervention is generally effective for improving prescribing behaviours. However, this intervention had mixed effects in one high quality review (Machado) for improving concordance outcomes. Five high quality reviews (Alldred, Buckley, Lemmens, Patterson, Royal) and one key review (Davey) had an insufficient number of studies to draw any conclusions about the effectiveness of the intervention.

Summary of Overall Findings from Reviews

28 reviews that evaluated the effectiveness of the revision of pharmacy roles were identified. Of these, 2/3 high quality/key reviews with a sufficient number of studies to draw conclusions found this intervention to be generally effective.

Summary of Findings Related to Prescribing

1/2 high quality/key reviews with a sufficient number of studies to draw conclusions found this intervention to be generally effective for improving prescribing outcomes.

Reviews listed as "Summary Pending" will be analyzed, summarized and reported at a later date.

The findings will then be incorporated in the overall evidence summaries of the interventions they address.

Reviews Addressing This Intervention Quality Assessment Tool:
AMSTAR Score (of 11 points)
Alldred DP, Raynor DK, Hughes C, Barber N, Chen TF, Spoor P. Interventions to optimise prescribing for older people in care homes. Cochrane Database of Systematic Reviews 2013 2:CD009095. 9 (High)
Nkansah N, Mostovetsky O, Yu C, Chheng T, Beney J, Bond C, Bero L. Effect of outpatient pharmacists' non-dispensing roles on patient outcomes and prescribing patterns. Cochrane Database of Systematic Reviews 2010 7:CD000336. 9 (High)
Patterson SM, Hughes C, Kerse N, Cardwell CR, Bradley MC. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database of Systematic Reviews 2012 5:CD008165. 9 (High)
Buckley BS, Byrne MC, Smith SM. Service organisation for the secondary prevention of ischaemic heart disease in primary care. Cochrane Database of Systematic Reviews 2010 3:CD006772. 8 (High)
Lemmens KMM, Nieboer AP, Huijsman R. A systematic review of integrated use of disease-management interventions in asthma and COPD. Respiratory Medicine 2009 103 (5):670-91. 8 (High)
Machado M, Nassor N, Bajcar JM, Guzzo GC, Einarson TR. Sensitivity of patient outcomes to pharmacist interventions. Part III: systematic review and meta-analysis in hyperlipidemia management. Annals of Pharmacotherapy 2008 42 (9):1195-207. 8 (High)
Royal S, Smeaton L, Avery AJ, Hurwitz B, Sheikh A. Interventions in primary care to reduce medication related adverse events and hospital admissions: systematic review and meta-analysis. Quality and Safety in Health Care 2006 15 (1):23-31. 8 (High)
Bayoumi I, Howard M, Holbrook A, Schabort I. Interventions to improve medication reconciliation in primary care. The Annals of Pharmacotherapy 2009 43 (10):1667-75. 7 (Medium)
Davey P, Brown E, Fenelon L, Finch R, Gould I, Hartman G, Holmes A, Ramsay C, Taylor E, Wilcox M, Wiffen P. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database of Systematic Reviews 2005 4:CD003543. 7 (Medium)
Forsetlund L, Eike MC, Gjerberg E, Vist GE. Effect of interventions to reduce potentially inappropriate use of drugs in nursing homes: a systematic review of randomised controlled trials. BMC Geriatrics 2011 11:16. 7
Summary Pending
Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Interventions used to improve control of blood pressure in patients with hypertension. Cochrane Database of Systematic Reviews 2010 3:CD005182. 7 (Medium)
Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, Whitty P, Eccles MP, Matowe L, Shirran L, Wensing M, Dijkstra R, Donaldson C. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technology Assessment 2004 8 (6):iii-iiv. 7 (Medium)
Hesselink G, Schoonhoven L, Barach P, Spijker A, Gademan P, Kalkman C, Liefers J, Vernooij-Dassen M, Wollersheim H. Improving patient handovers from hospital to primary care: a systematic review. Annals of Internal Medicine 2012 157 (6):417-428. 7
Summary Pending
Machado M, Iskedjian M, Ruiz IA, Einarson TR. The economic impact of introducing serotonin-noradrenaline reuptake inhibitors into the Brazilian national drug formulary: cost-effectiveness and budget-impact analyses. PharmacoEconomics1 2007 25 (11):979-90. 7 (Medium)
Holland R, Desborough J, Goodyer L, Hall S, Wright D, Loke YK. Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. British Journal of Clinical Pharmacology 2008 65 (3):303-16. 6 (Medium)
Koshman SL, Charrois TL, Simpson SH, McAlister FA, Tsuyuki RT. Pharmacist care of patients with heart failure: a systematic review of randomized trials. Archives of Internal Medicine 2008 168 (7):687-94. 6 (Medium)
Williams A, Manias E, Walker R. Interventions to improve medication adherence in people with multiple chronic conditions: a systematic review. Journal of Advanced Nursing 2008 63 (2):132-43. 6 (Medium)
Bennett MI, Bagnall AM, Raine G, Closs SJ, Blenkinsopp A, Dickman A, Ellershaw J. Educational interventions by pharmacists to patients with chronic pain: Systematic review and meta-analysis. The Clinical Journal of Pain 2011 27 (7):623-630. 5 (Medium)
Castelino R, Bajorek B, Chen T. Targeting suboptimal prescribing in the elderly: a review of the impact of pharmacy services. The Annals of Pharmacotherapy 2009 43 (6):1096-106. 5 (Medium)
De Bleser L, Matteson M, Dobbels F, Russell C, De Geest S. Interventions to improve medication-adherence after transplantation: a systematic review. Transplant International 2009 22 (8):780-97. 5 (Medium)
Ellitt GR, Brien JA, Aslani P, Chen TF. Quality patient care and pharmacists' role in its continuity--a systematic review. Annals of Pharmacotherapy 2009 43 (4):677-91. 5 (Medium)
Hakkennes S, Dodd K. Guideline implementation in allied health professions: a systematic review of the literature. Quality and Safety in Health Care 2008 17 (4):296-300. 5 (Medium)
Hodgkinson B, Koch S, Nay R, Nichols K. Strategies to reduce medication errors with reference to older adults. International Journal of Evidence-Based Healthcare 2006 4 (1):15008. 5
Summary Pending
Schlenk EA, Bernardo LM, Organist LA, Klem ML, Engberg S. Optimizing medication adherence in older patients: a systematic review. Journal of Clinical Outcomes Management 2008 15 (12):595-606. 5 (Medium)
Aguiar PM, Balisa-Rocha BJ, Brito GC, da Silva WB, Machado M, Lyra DP. Pharmaceutical care in hypertensive patients: a systematic literature review. Research in Social & Administrative Pharmacy 2012 8 (5):383-396. 4
Summary Pending
Al-Jumah KA, Qureshi NA. Impact of pharmacist interventions on patients' adherence to antidepressants and patient-reported outcomes: a systematic review. Patient Preference and Adherence 2012 6:87-100. 4
Summary Pending
Chhabra PT, Rattinger GB, Dutcher SK, Hare ME, Parsons KL, Zuckerman IH. Medication reconciliation during the transition to and from long-term care settings: a systematic review. Research in Social & Administrative Pharmacy 2012 8 (1):60-75. 4
Summary Pending
Chisholm-Burns M, Kim LJ, Spivey C, Slack M, Herrier R, Hall-Lipsy E, Graff ZJ, Abraham I, Palmer J, Martin J, Kramer S, Wunz T. US pharmacists' effect as team members on patient care: systematic review and meta-analyses. Medical Care 2010 48 (10):923-33. 4 (Medium)
Fish A, Watson MC, Bond CM. Practice-based pharmaceutical services: a systematic review. International Journal of Pharmacy Practice 2002 10 (4):225-33. 4 (Medium)
Ioannidis JP, Lau J. Evidence on interventions to reduce medical errors: an overview and recommendations for future research. Journal of General Internal Medicine 2001 16 (5):325-34. 4 (Medium)
Loganathan M, Singh S, Franklin BD, Bottle A, Majeed A. Interventions to optimise prescribing in care homes: systematic review. Age and Ageing 2011 40 (2):150-162. 4 (Medium)
Morecroft CW, Ashcroft DM, Noyce PR. Repeat dispensing of prescriptions in community pharmacies: a systematic review of the UK literature. International Journal of Pharmacy Practice 2006 14 (1):11-19. 4 (Medium)
Morrison A, Wertheimer AI. Evaluation of studies investigating the effectiveness of pharmacists' clinical services. American Journal of Health-System Pharmacy 2001 58 (7):569-77. 4 (Medium)
Mueller SK, Sponsler KC, Kripalani S, Schnipper JL. Hospital-based medication reconciliation practices: a systematic review. Archives of Internal Medicine 2012 172 (14):1057-1069. 4
Summary Pending
Saberi P, Dong BJ, Johnson MO, Greenblatt RM, Cocohoba JM. The impact of HIV clinical pharmacists on HIV treatment outcomes: a systematic review. Patient preference & adherence 2012 6:297-322. 4
Summary Pending
Singhal PK, Raisch DW, Gupchup GV. The impact of pharmaceutical services in community and ambulatory care settings: evidence and recommendations for future research. The Annals of Pharmacotherapy 1999 33 (12):1336-55. 4 (Medium)
Alsulami Z, Conroy S, Choonara I. Medication errors in the Middle East countries: a systematic review of the literature. European Journal of Clinical Pharmacology 2013 69 (4):995-1008. Summary Pending
Altowaijri A, Phillips CJ, Fitzsimmons D. A systematic review of the clinical and economic effectiveness of clinical pharmacist intervention in secondary prevention of cardiovascular disease. Journal of Managed Care Pharmacy 2013 19 (5):408-416. Summary Pending
Lee JK, Slack MK, Martin J, Ehrman C, Chisholm-Burns M. Geriatric patient care by U.S. pharmacists in healthcare teams: systematic review and meta-analyses. Journal of the American Geriatrics Society 2013 61 (7):1119-1127. Summary Pending
Michot P, Catala O, Supper I, Boulieu R, Zerbib Y, Colin C, Letrilliart L. Cooperation between general practitioners and pharmacists: a systematic review. Sante Publique (Vandoeuvre-Les-Nancey) 2013 25 (3):331-341. Summary Pending
Tjia J, Velten SJ, Parsons C, Valluri S, Briesacher BA. Studies to reduce unnecessary medication use in frail older adults: a systematic review. Drugs & Aging 2013 30 (5):285-307. Summary Pending