Medication review service implementation in community pharmacy settings: Scoping review with focus on implementation studies

Abstract

Background: Medication reviews are a structured clinical intervention with the general goals of improving patient drug knowledge and detecting and resolving drug-related problems in an individual patient's medication regimen. A variety of barriers entrenched in the traditional drug distribution and dispensing model of pharmacy business has continued to challenge the implementation efforts of medication review services worldwide in the community pharmacy setting.Main Objectives: i) Characterize original research studies that sought to enhance medication review service implementation in community pharmacy settings. ii) Categorize the broader corpus of scientific literature (beyond original implementation studies) on medication review service implementation in community pharmacy settings.Methods: a broad systematic search strategy was applied to ovid MEDLINE, Embase, CINAHL and Cochrane Library to create an over-arching view and extensively ordered bibliography of the diverse research publication types dealing with the topic of medication review service implementation in the community pharmacy setting. A scoping review was subsequently conducted on original research studies that utilized various strategies to enhance the implementation of this service in community pharmacies. Data-charting evaluated the location of implementation studies, the strategies undertaken, the scale of implementation strategies, the use of DII (Dissemination, Implementation and Improvement) science theory, sample sizes, and DII outcomes.Results: Of 5,947 records screened, 419 fulfilled the inclusion criteria (from abstract screening) to be deemed suitable for categorization and inclusion into the broader survey on this topic. Of these 419 publications, only 75 were original research specifically focused on enhancing the implementation of medication reviews in community pharmacy. A large majority of the publications were qualitative studies (n = 203). The remaining articles were improvement studies (n = 36), descriptive observational studies (n = 49), reviews (n = 69) and methodology papers (n = 16). Twenty-nine of these articles were deemed suitable for inclusion in more than one category. After full-text screening, 41 of the 75 implementation publications, representing 40 original studies, published between 1999-2019, were eligible for data-charting. The majority of these studies occurred in North America (n = 30), used some form of education as the most common implementation strategy (n = 22) and measured 'adoption' (extent or frequency of medication reviews delivered) most frequently as an implementation outcome (n = 30). Just over half of the studies used a multi-faceted implementation strategy (n = 21). Only 9 studies used a theory, model or framework at any point in the research process to test hypotheses or explain empirical findings. Conclusions:There is an abundance of publications addressing various issues surrounding medication review implementation in community pharmacies. However, the literature appears disproportionately repre...

Comprehensive Medication Management Services with a Holistic Point of View, a Scoping Review

“…In contrast to Brant’s research [ 28 ], qualitative studies did not numerically dominate our scoping review. Some studies included aspects related to pharmacist attitudes [ 219 , 220 ].…”

“…Previous examination of the literature about the implementation of these services has already been useful to inform further improvements in clinical pharmacy services. The scoping reviews have been conducted on the implementation of medication review services in community pharmacies [ 28 ], medicine use review in the United Kingdom [ 29 ], medication reconciliation at patient discharge [ 30 ], use and impact of telehealth medication reviews [ 31 ] and identification of strategies and interventions improving interprofessional collaboration and integration in primary care [ 32 ]. This review aims to identify the scientific evidence related to a holistic approach, as described above, without limiting it to a particular healthcare setting.…”

Pharmacy practice research – A call to action

“…Extensive research has been undertaken to explore barriers and facilitators for services implementation. However, there has been a call for more rigorous implementation studies in pharmacy, which should consider using implementation theories, frameworks or models and report on appropriate implementation outcomes 44 . Therefore, researchers may want to question themselves: Has an implementation theory, model or framework been selected?…”

Barriers to Medication Review Process Implementation—Cross-Sectional Study among Community Pharmacists in Jordan

“…Studies addressed the MRP's positive outcomes on patients' life, particularly the elderly, who receive more than one drug for a long time. That is, the ultimate goal of the MRP is to obtain the best possible treatment plan, improve the patient's quality of life, reduce treatment costs, increase commitment to taking medication, and reduce potential medication-related side effects [10][11][12][13][14][15][16][17][18][19][20][21]. Therefore, the basis forconducting the process depends mainly on engaging indialogue with the patient to obtain all of the necessary information that mainly affects the treatment plan and the extent of the patient's commitment to taking the medications included in the treatment plan completely and appropriately, thus ensuringthat the correct patient receives the correct medication at the correct dose [22].…”

“…Although the MRP is widely adopted and studied globally [13,25], it is seldom provided bycommunity pharmacies in Jordan [23,24]. There is a lack of studies that address the potential barriers that hinderthe adoption of such a service bycommunity pharmacies.…”