Clinical pharmacy services in Brazil, particularly cardiometabolic diseases: a systematic scoping review and meta-analyses
| Autor: | Priscila L. Nassur, Marcela Forgerini, Patricia C. Mastroianni, Rosa C. Lucchetta |
|---|---|
| Přispěvatelé: | Universidade Estadual Paulista (Unesp) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
process assessment health care
Cost-Benefit Analysis pharmacists lcsh:RS1-441 Pharmaceutical Science Pharmacy Pharmacists metabolic diseases 030226 pharmacology & pharmacy mesh:Medication Therapy Management mesh:Diabetes Mellitus mesh:Quality of Life chemistry.chemical_compound 0302 clinical medicine mesh:Brazil mesh:Hypertension mesh:Reproducibility of Results Original Research education.field_of_study Cost–benefit analysis Process Assessment Health Care meta-analysis as topic brazil Cardiovascular Diseases diabetes mellitus Hypertension mesh:Cardiovascular Diseases mesh:Systematic Reviews as Topic Brazil systematic reviews as topic medicine.medical_specialty hypertension Medication Therapy Management Population Community Pharmacy Services medication therapy management lcsh:Pharmacy and materia medica mesh:Community Pharmacy Services 03 medical and health sciences pharmaceutical services pharmacies Metabolic Diseases Meta-Analysis as Topic Diabetes mellitus Medication therapy management Diabetes Mellitus medicine mesh:Pharmacists education Pharmacies business.industry cost-benefit analysis lcsh:RM1-950 mesh:Pharmacies Reproducibility of Results mesh:Process Assessment Health Care medicine.disease community pharmacy services cardiovascular diseases Clinical pharmacy mesh:Pharmaceutical Services lcsh:Therapeutics. Pharmacology Blood pressure mesh:Cost-Benefit Analysis mesh:Meta-Analysis as Topic quality of life chemistry Pharmaceutical Services Emergency medicine Quality of Life reproducibility of results Glycated hemoglobin business mesh:Metabolic Diseases Systematic Reviews as Topic |
| Zdroj: | Pharmacy Practice Pharmacy Practice (Granada) v.18 n.4 2020 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname Pharmacy Practice, Vol 18, Iss 4, p 2131 (2020) SciELO España: Revistas Científicas Españolas de Ciencias de la Salud Instituto de Salud Carlos III (ISCIII) Scopus Repositório Institucional da UNESP Universidade Estadual Paulista (UNESP) instacron:UNESP |
| ISSN: | 1886-3655 1885-642X |
| Popis: | Made available in DSpace on 2021-06-25T10:44:53Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 Objective: To map the clinical pharmacy services conducted in Brazil, their characteristics, outcomes, and process measures in general population, as well as the assessment of the clinical impact on people with cardiometabolic diseases (cardiovascular diseases and metabolic diseases). Methods: A systematic scoping review and meta-analysis were conducted. The electronic searches were re-run in March 2020. To the clinical impact assessment, meta-analyses of cardiometabolic outcomes (i.e., change of systolic (SBP) and diastolic blood pressure (DBP), triglycerides, total cholesterol, glycated hemoglobin (HbA1c), fasting glycemia, LDL-, and HDL-cholesterol) were led. The risk of bias was assessed with the Cochrane Collaboration tools. Results: 71 studies were identified (7,402 patients), being the majority quasi-experimental studies (n=41) and published by research groups of Southeast Brazil (n=33). Medication therapy management (n=62) was the most frequent clinical pharmacy service, performed on outpatient setting (n=45), with adults or elderly people (n=58) with hypertension (n=18) or diabetes (n=10). Process measures (n=58) (e.g. resolution of drug related-problem) were widely used as indicator, followed by clinical (n=44) (e.g. change in SBP), humanistic (n=12) (e.g. change in quality-of-life score assessed by Short-Form 36 Health Survey Questionnaire), and economic outcomes (n=3) (incremental cost-effectiveness ratio for reduction in HbA1c). Regarding the assessment of clinical impact of the services, 20 studies were included in meta-analyses, showing improvement in most cardiometabolic outcomes when considered individual studies. However, the evidence presents high risk of bias, high heterogeneity (median 67-90%) and imprecision, contributing to wide prediction intervals and low reliability. Conclusions: A predominance of studies on cardiometabolic diseases, process measures, and clinical outcomes were identified. Considering the assessment of the clinical impact of clinical pharmacy services in cardiometabolic diseases, an improvement in most cardiometabolic outcomes was showed, however, with low confidence and wide prediction interval. Therefore, development of larger studies with low risk of bias and major homogeneity is necessary for a better comprehension of clinical pharmacy service characteristics, benefits, and the population groups most benefited. Department of Drugs and Medicines School of Pharmaceutical Sciences São Paulo State University (UNESP) Department of Drugs and Medicines School of Pharmaceutical Sciences São Paulo State University (UNESP) |
| Databáze: | OpenAIRE |
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