The effect of community pharmacy-based interventions on patient health outcomes: a systematic review

Abstract

Many studies have demonstrated the beneficial effects that pharmacist-provided patient care services can have on patient health outcomes. However, the effectiveness of patient care services delivered by pharmacists in community pharmacy settings, where organizational barriers may affect service implementation or limit effectiveness, remains unclear. The authors systematically reviewed the literature on the effectiveness of pharmacist-delivered patient care services in community pharmacy settings in the United States. Of the 749 articles retrieved, 21 were eligible for inclusion in the review. Information concerning 134 outcomes was extracted from the included articles. Of these, 50 (37.3%) demonstrated statistically significant, beneficial intervention effects. The percentage of studies reporting favorable findings ranged from 50% for blood pressure to 0% for lipids, safety outcomes, and quality of life. Our findings suggest that evidence supporting the effectiveness of pharmacist-provided direct patient care services delivered in the community pharmacy setting is more limited than in other settings.

Keywords: community pharmacies; direct patient care; pharmacists; systematic review.

Figure 1

Conceptual model.

Figure 2

Selection of studies for inclusion in review.

Figure 3

Outcomes of studies evaluating the effects of pharmacist-delivered patient care services, aggregated across settings and limited to studies conducted in community pharmacy settings. Note: Data shown for the aggregated findings are based on results reported by Chisholm-Burns et al. (2010). Data for the community pharmacy settings are based on results from the 21 articles included in the current review. Outcomes were classified using the following criteria: favorable = statistically significant beneficial effects associated with pharmacist care on all measures of the outcome; mixed = statistically significant beneficial effects associated with pharmacist-provided care on some, but not all measures of the outcome; null = no statistically significant differences observed.