Skip to main content

Table 2 Description of the interventions and detailed clinical, economic or humanistic primary outcomes of papers included

From: Systematic review of pragmatic randomised control trials assessing the effectiveness of professional pharmacy services in community pharmacies

Author
PPS
PPSs components Health outcomes
[67] Al Hamarneh
MTM
Assessment of patient’s therapies and laboratory results, individualized CV risk assessment, adjustment of treatment regimen, prescribing and ordering laboratory tests to meet treatment targets, and self-report of adverse events. Regular communication after each contact with the patients and regular follow-up visits every 4 weeks for 3 months. Improvement of: CV risk (absolute reduction 5.38%; 95%CI, 4.24–6.52; P < 0.001), (HbA1c (0.9%; 95%CI, 0.70–1.10; P < 0.001), systolic blood pressure (8.6 mmHg; 95%CI, 6.70–10.40; P < 0.001), diastolic blood pressure (2.7 mmHg; 95%CI, 1.30–4.10; P < 0.001), LDL-cholesterol, (0.2 mmol/L; 95%CI, 0.10–0.30; P = 0.004) and Tobacco use (24.2% P < 0.001).
[51] Armour
DSM/MTM
Brief health education tips. Inhalation technical instruction.
Letter written to the doctor for the action plan. Asthma control and spirometry performed at every visit measured using questionnaires and spirometers.
Improvement of: percentage of patients achieving a good/fair control in both groups 4-visit service: from 21 to 59%; 3-visit service: from 29 to 61% (mean = 0.57 for the three-visit group, 0.56 for the four-visit group, P < .001). Improvement of the health-related quality of life (Three visit 4.13 ± 1.41 to 3.39 ± 1.19; P < .001- versus Four-visit 4.45 ± 1.49 to 3.57 ± 1.48; P < .001). No significant differences of asthma control between patients receiving 4 visits compared to patients receiving 3 visits.
[49] Costello
Smoking cessation
Pharmacist – led behavioural counselling combined with nicotine replacement therapy (NRT). 1 (Group B) to 3 (Group A) face-to-face sessions for behaviour change to quit smoking. On-line control surveys at 7 days, and 5 and 12 weeks. Phone calls to those who did not attend the visits or respond. There were statistically significant differences between each of the two groups receiving the service and the group of patients that only received NTR by mail (control group) 3-session service (× 2 = 217.30, P < 0.001; ITT: × 2 = 149.60, P < 0.001); 1-session service (× 2 = 93.90, P < 0.001; ITT: × 2 = 19.00, P < 0.001).
[68] Elliot
NMS
Pharmacist and GP service offering to the patient. The pharmacist asks about adherence and medicines. One-to-one consultation 7–14 days after the presentation of the prescription with a ‘follow-up’ of 14–21 days via telephone. Improvement of the percentage of adherent patients 1.67 (95%CI, 1.06–2.62; P = 0.027). Non-significant reductions of health system costs (£21; 95%CI, £59 - £150; P = 0.1281).
[69] Geurts
MTM
Pharmaceutical care Process (PCP) in cooperation between patient’s pharmacist and GP, and agreed to by the patient: (1) assessment of potential DRPs and pharmaceutical care issues (PCIs), (2) proposal of interventions to reach treatment goals, and (3) implementation of the interventions. Two measurements were performed, (t = 0) at the beginning and (t = 1) after 1-year follow up. Decrease of diastolic BP (95%CI, 79.80–76.80 mmHg; P = 0.008) and increase of HDL-cholesterol: IG (IG: 95%CI, 1.29–1.37 mmol/L; P = 0.021; IG patients not receiving the whole service: 95%CI, 1.26–1.37 mmol/L; P = 0.039); and GC: (95%CI, 1.30–1.36 mmol/L; P = 0.074). Non-significant decrease of LDL-cholesterol: IG (IG: 95%CI, 2.72–2.63 mmol/L; P = 0.337; IG patients not receiving the whole service: 95%CI, 2.98–2.67 mmol/L; P = 0.740); and CG: (95%CI, 2.61–2.58 mmol/L; P = 0.032).
[70] Planas
MTM
1-h face to face interview on a monthly basis (IG) and 30 min face to face interview at 3- month intervals (CG).
IG: 1) Provision of written patient education materials. 2) Diabetes education, coaching on self-management skills and medication adherence. 3) Assessment of medications and DRP. 4) Contact with GP via fax or telephone to recommend treatment adjustments.
Improvement of the percentage of patients achieving the control of their health problem: HbA1c (IG: 46.70% vs. CG: 9.10%, P < 0.002), blood pressure (IG: 53.30% vs. CG: 22.70%, P < 0.020). Non-statistically significant higher percentage of patients achieving the LDL target levels (IG: 50.00% vs. CG: 46.70%, P = 0.460).
[71] Rubio-Valera
Dispensing/ Adherence service
First visit: educational intervention centred on improving patients’ knowledge of antidepressants and awareness of the importance of adherence and quality of life. Subsequent visits: short review of some points covered in the first visit and checking of patient progress. Improvement of the health-related quality of life (0.25 vs. 0.14) - effect size 0.31 vs 0.33 -. No statistically significant differences in adherence, satisfaction or clinical severity depression.
[72] Stewart
Adherence service
Home BP monitor. Training on BP self-monitoring (3–6-month follow-ups). Motivational interviewing and education to medication adherence. Medication use review. Referral to a GP
Prescription refill reminders.
Improvement of the proportion of adherent patients although there were not significant differences between groups (57.2 to 63.6% CG vs 60.0 to 73.5% IG, P = 0.23). Reduction of systolic BP was significantly greater in the IG (7.2 mmHg 95%CI 1.6 12.8 mmHg; P = 0.001). Reductions in BP of 10.00 mmHg (IG) vs. 4.60 mmHg (CG); P = 0.050. Improvement of percentage of non-adherent patients becoming adherent 22.60% (95%CI, 5.10–40.00%) in the IG compared to CG (IG: 61.80% vs. CG: 39.20%; P = 0.007).
[73] Tommelein
MTM
Educational intervention (two sessions of 15–25 min).
Electronically recorded medication, inhalation technique and questionnaires about behavioural issues, etc.
Letter to the patient’s GP.
Significantly lower estimated annual severe exacerbation rate in the IG compared with the CG (0.27 (IG) vs. 0.61 (IC): RR = 0.45; 95%CI, 0.25–0.80; P < 0.007). Also, significantly 72% lower estimated annual hospitalization rate in IG vs CG (0.10 vs. 0.40; RR = 0.28; 95% CI, 0.12–0.64; P = 0.003) and a statistically significant 73% lower rate of hospitalization days (0.87 vs. 3.51; RR, 0.27; 95%CI, 0.21–0.35; P < 0.0001).
74] Tsuyuki
Independent prescribing
Assessment of BP and cardiovascular risk. Education on arterial hypertension. Prescribing of antihypertensive medications.
Laboratory monitoring and monthly follow-up visits for 6 months. Provision of a wallet card for BP recording.
Greater reduction of systolic BP in the IG of 6.60 (1.90) mmHg (P = 0.0006) and proportion of patients achieving target BP 58% (IG) vs. 37% (CG), P = 0.020); OR = 2.32 (95%CI, 1.17–4.15).
[75] Verdoorn
CMR/MTM
First visit: a patient interview for gathering information (health problems, preferences, and all medications used). Identify potential DRPs and propose recommendations to solve them. Subsequent visits: face-to-face meeting with the patient’s GP to discuss all health-related goals and DRPs. Two follow up appointments. Improvement of the health-related quality of life: 3 months 1.70 points (95% CI, 0.47–2.90; P = 0.006) and 6 months 3.40 points (95% CI, 0.94–5.80; P = 0.006).
[76] Zillich
Telephone MTM
Home episodic skilled nursing care. Medication information was faxed from nurse to the provider. Initial phone call by a pharmacy technician to verify active drugs. Pharmacist-provided telephone MTM.
Follow - up pharmacist phone calls at 7-day and as needed for 30 day of the 60-day home health care episodes.
Significant less probability of hospital readmission in patients with a low baseline risk (adjusted OR: 3.79; 95%CI, 1.35–10.57; P = 0.01). No significant differences in the 60- day probability of hospitalizations adjusted OR: 1.26; (95%CI, 0.89–1.77; P = 0.190).
\