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Community pharmacists show inconsistent impact

Community pharmacists show inconsistent impact

Community pharmacists effectively address medication-related problems following patients' discharge from hospital but their €impact on other outcomes is not consistent€, according to the British Journal of Clinical Pharmacology.

Hamde Nazar, a pharmacist from Durham University, and co-authors, reviewed 14 studies assessing post-discharge interventions that involved community pharmacy. The four studies examining medication errors found that community pharmacists significantly improved the identification and rectification of drug-related problems. These studies were €clearly designed€ around €a focused outcome€ and pharmacists adhered to appropriately structured protocols.

Other patient outcomes €“ including adherence and clinical control €“ did not show a uniform advantage or disadvantage from community pharmacists' involvement, although the studies were inconsistently implemented and evaluated. The authors comment that, €due to the design and implementation of many of the remaining studies, the full potential of the interventions may not have been fully appreciated€. The €insufficient data and flawed study design and implementation mean that further impact on patient outcomes cannot be deduced€.

The authors call for randomised controlled trials with €more stringent€ control arms than €uncontrolled 'usual care'€ and that include €process evaluations as standard€ to allow for contextual factors. They note that if €other interventions €¦ robustly demonstrate€ such improvements, €the clinical qualities and role of community pharmacy in patient care will not be fully realised and possibly ignored€. (doi:10.1111/bcp.12718)

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