Background
Method
Literature search strategy
Selection of articles
Results
Pharmacists’ roles – Current scenario in developing countries
Authors | Country | Setting | Study design | Participants | Objectives of the study | Outcomes of the study |
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Yu Fang et al., 2011 [23] | China | Community | Questionnaire based survey | Pharmacists | To explore the perceptions of community pharmacists towards the concept of pharmaceutical care, and barriers to implementation of pharmaceutical care in China | Lack of external conditions for developing or providing pharmaceutical care, lack of time and skills, absence of information and economic incentive, and lack of full support from other health professionals. |
Hashmi et al., 2017 [24] | Pakistan | Community | Semi-structured interview - qualitative | Pharmacists | To explore knowledge, perception and attitude of community pharmacists about extended pharmaceutical services in the city of Lahore, Pakistan | Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures |
Kho et al., 2017 [26] | Malaysia | Community | Semi-structured interview - qualitative | Pharmacists | To obtain in-depth information on the provision of professional pharmacy services by community pharmacies in Sarawak, Malaysia | Lack of time, personnel and physical space constrained services provision, cultural issues, lack of committed customers, stock availability and price issues |
Sancar et al., 2013 [25] | Turkey | Community | Questionnaire based survey | Pharmacists | To assess Turkish community pharmacists’ points of view about pharmaceutical care practice in Turkey | Lack of knowledge of drugs and disease states, lack of technical knowledge of how to provide pharmaceutical care practice, lack of communication with physicians and stationary workload |
Bilal et al., 2017 [27] | Ethiopia | Hospital | Cross-sectional survey | Pharmacists | To assess the status, challenges and way forward of clinical pharmacy services in Ethiopia | Shortage of staff, lack of awareness, lack of support from management, hospital setup, incentives, and gaps in the curriculum |
Salim et al., 2016 [28] | Sudan | Hospital | Exploratory corss-sectional study | Pharmacists | To explore the self-perception of clinical pharmacists of their impact on healthcare in Khartoum State, Sudan | Shortage of pharmacy staff, lack of support from health authorities, lack of training and educational program, lack of job descriptions, lack of specific area in patient files for clinical pharmacist intervention, and low salaries |
AbuRuzet al., 2012 [30] | Jordan | Community | Questionnaire based survey | Pharmacists | To study about the role of community pharmacists in Jordan | Lack of pharmaceutical care training, lack of access to medical files, lack of space, physicians’ acceptance, communication with physicians and lack of local data |
El Hajj et al., 2016 [32] | Qatar | All areas | Cross-sectional survey | Pharmacists | To examine the extent of pharmaceutical care practice and the barriers to pharmaceutical care provision as perceived by Qatar pharmacists | Inadequate training in pharmaceutical care, lack of documentation skills, lack of pharmaceutical care role models, insufficient opportunity for interaction with other health care providers, inconvenient access to patient medical records, insufficient staff and lack of privacy, time, space |
Katoue et al., 2014 [31] | Kuwait | Hospital | Cross-sectional survey | Pharmacists | To investigate hospital pharmacists’ attitudes towards pharmaceutical care, and the barriers to its implementation in Kuwait | Lack of private counselling areas, organizational obstacles, inadequate staff, lack of pharmacist time and adequate technology |
Farina et al., 2009 [29] | Brazil | Community | Questionnaire based survey | Pharmacists | To learn about the professional practice of the pharmacists who work in pharmacies and their knowledge and perceptions about pharmaceutical care | Lack of time, of support from the pharmacy owner, and patient’s disinterest |
Pharmacists’ involvement in optimising medicines
AMR-related interventions led by pharmacists in developing and developed countries
Authors | Country | Setting | Objective | Study design | Type of intervention | Relevant outcomes |
---|---|---|---|---|---|---|
Brink et al., 2017 [97] | South Africa | Hospital | To implement an improvement model for existing resources, in order to achieve a reduction in surgical site infections (SSIs) across a heterogeneous group of 34 urban and rural South African hospitals | A pharmacist-driven, prospective audit and feedback strategy | Pharmacist included in the post-pharmacist intervention | pharmacists can effectively improve guideline compliance and sustainable patient outcomes(P < 0.0001) |
Ellis et al., 2016 [36] | USA | Hospital | To assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric unit | Pre and Post - pharmacist intervention | Pharmacist included in the post-pharmacist intervention | Post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (p = 0.02), pharmacist intervention group had less antibiotics prescribed for an inappropriate duration(p < 0.01), post intervention group had medications prescribed with appropriate dose, duration, and indication(p = 0.04) |
Okada et al., 2016 [37] | Japan | Hospital | To investigate the clinical effectiveness of the pharmacist interventions on antibiotic use | Retrospective study design | Pharmacist included in the intervention group | Effective drug concentrations significantly increased in the intervention group. Intervention (74%) and control (55%). |
Northey et al., 2015 [38] | Australia | Community | To assess the effectiveness of involving community pharmacy staff in patient education about antibiotic resistance | Randomized control study | Those in the intervention group were provided with verbal education by pharmacists | Antibiotic knowledge increased after receiving verbal antibiotic education (p = 0.008) |
Zhou et al., 2015 [34] | China | Hospital | To describe the impacts of pharmacist intervention on the use of antibiotics, particularly in urology clean operations | Pre and Post - pharmacist intervention | Pharmacist included in the post intervention group | Average antibiotic cost decreased, cost of antibiotics as a percentage of total drug cost decreased by 27. 7%; the rate of use of antibiotics decreased from 100% to 7.3% |
Booth et al., 2013 [10] | UK | Community | To compare the care pathway of patients with UTI symptoms attending GP services with those receiving management, including trimethoprim supply under PGD, via community pharmacies | Prospective, cross-sectional, mixed methods | Pharmacies invited a purposive sample of female patients to participate | Antibiotic treatments for UTIs could be provided via community pharmacy to improve patient access to treatment which may also maintain antibiotic stewardship and reduce GP workload |
Magedanz et al., 2012 [9] | Brazil | Hospital | To assess the impact of ASP, with and without the presence of a pharmacist, in a cardiology hospital in Brazil | Pre and Post pharmacist intervention | Pharmacist included in the post-pharmacist intervention | Adherence to recommendations was increased (64%), hospital antibiotic cost reduction (69%). |
Yen et al., 2012 [39] | Taiwan | Hospital | A pharmacist-managed antibiotic intravenous to oral (i.v.-to-p.o.) conversion program has been incorporated to minimize unnecessary i.v. antibiotic usage | Retrospectively collected by chart review | Pharmacist included in the intervention group | Length of hospital stay was significantly decreased (p = 0.001) |
Dunn et al., 2011 [40] | Ireland | Hospital | To assess the impact of the introduction of guidelines and criteria for switching to oral antimicrobials | prospective and of controlled before and after design | Pharmacist included in the intervention group | Duration of IV antimicrobial treatment reduced significantly in the study group post intervention, (P = 0.02) compared to the control group |
Grill et al., 2011 [41] | Germany | Hospital | To assess the impact of pharmaceutical consulting on the quality of antimicrobial use in a surgical hospital department | Prospective controlled intervention study | Pharmacist included in the intervention group | Intervention reduced the length of antimicrobial courses (IG = 10 days, CG = 11 days, incidence rate ratio for i.v. versus o.p. = 0.88, 95% confidence interval 0.84 to 0.93) and shortened i.v. administration (IG = 8 days, CG = 10 days, hazard rate = 1.76 in favour of switch from i.v. to p.o., 95% confidence interval 1.23 to 2.52). 95% confidence interval 1.23 to 2.52 |
Shen et al., 2011 [35] | China | Hospital | To evaluate the impact of pharmacist interventions on antibiotic use in inpatients with respiratory tract infections in a tertiary hospital in China | Randomized control study | Pharmacist included in the intervention group, no pharmacist in the control group | Total costs of hospitalization in the intervention group was lower compared to the control group P < 0.001. Total cost of antibiotics in the intervention group was lower to the control group (P = 0.01). Patients required shorter length of hospital stay (P = 0.03) |
Hersberger et al., 2009 [42] | Switzerland | Community | To examine prescribing patterns of antibiotics and symptomatic medications for ARTI in Swiss primary care and to monitor pharmacists’ interventions during the prescription-dispensing process | Cluster randomized trial | Pharmacist included in the intervention group | Most patients (80%) were treated only with symptomatic medications. Most frequently prescribed symptomatic ARTI medications were nasal decongestants (39%), cough suppressants (36%), and mucolytic (31%) |