A Systematic Review of Evidence Based Community Pharmacy Services Aimed at the Prevention of Cardiovascular Disease.
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death worldwide and has a substantial impact on people's health and quality of life. CVD also causes an increased use of health care resources and services, representing a significant proportion of health care expenditure. Integrating evidence based community pharmacy services is seen as an asset to reduce the burden of CVD on individuals and the health care system. OBJECTIVES To (a) identify community pharmacy evidence based services designed to help prevent CVD and (b) provide fundamental information that is needed to assess their potential adaptation to other community pharmacy settings. METHODS This review used the DEPICT database, which includes 488 randomized controlled trials (RCT) that address the evaluation of pharmacy services. Articles reviewing these RCTs were identified for the DEPICT database through a systematic search of the following databases: MEDLINE, Scopus, SciELO (Scientific Electronic Library Online) and DOAJ (Directory of Open Access Journals) The DEPICT database was reviewed to identify evidence based services delivered in the community pharmacy setting with the purpose of preventing CVD. An evidence based service was defined as a service that has been shown to have a positive effect (compared with usual care) in a high quality RCT. From each evidence based service, fundamental information was retrieved to facilitate adaptation to other community pharmacy settings. RESULTS From the DEPICT database, 14 evidence based community pharmacy services that addressed the prevention of CVD were identified. All services, except 1, targeted populations with a mean age above 60 years. Pharmacy services encompassed a wide range of practical applications or techniques that can be classified into 3 groups: activities directed at patients, activities directed at health care professionals, and assessments to gather patient related information in order to support the previous activities. CONCLUSIONS This review provides pharmacy service planners and policymakers with a comprehensive list of evidence based services that have the potential to be adapted to different settings from which they were originally implemented and evaluated in order to reduce the burden of CVD. DISCLOSURES Funding for this review was provided by the University of Technology Sydney Chancellor's Postdoctoral Fellowship awarded to Sabater Hernandez. No other potential conflict of interest was declared. Study concept and design were contributed by Sabater Hernandez, Fernandez Llimos, Rotta, and Correr. Sabater Galindo and Sabater Hernandez took the lead in data collection, along with Franco Trigo and Rotta. Data interpretation was performed by Sabater Hernandez, Durks, and Lopes. The manuscript was written primarily by Sabater Hernandez, along with Hossain, and revised by Fernandez Llimos, Rotta, and Benrimoj, with assistance from Durks, Sabater Galindo, Franco Trigo, and Correr.
Journal of managed care specialty pharmacy