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The effectiveness of integrating clinical pharmacists within general practice to optimise prescribing and health outcomes in primary care patients with polypharmacy: a protocol for a systematic review [version 2; peer review: 2 approved]

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posted on 2024-05-30, 11:13 authored by Aisling Croke, Oscar James, Barbara ClyneBarbara Clyne, Frank MoriartyFrank Moriarty, Karen Cardwell, Susan SmithSusan Smith
Introduction: Coordinating prescribing for patients with polypharmacy is a challenge for general practitioners. Pharmacists may improve management and outcomes for patients with polypharmacy. This systematic review aims to examine the clinical and cost-effectiveness of pharmacist interventions to optimise prescribing and improve health outcomes in patients with polypharmacy in primary care settings. 
Methods: The review will be reported using the PRISMA guidelines. A comprehensive search of 10 databases from inception to present, with no language restrictions will be conducted. Studies will be included where they evaluate the clinical or cost-effectiveness of a clinical pharmacist in primary care on potentially inappropriate prescriptions using validated indicators and number of medicines. Secondary outcomes will include health related quality of life measures, health service utilisation, clinical outcomes and data relating to cost effectiveness. Randomised controlled trials, non-randomised controlled trials, controlled before-after, interrupted-time-series and health economic studies will be eligible for inclusion. 
Titles, abstracts and full texts will be screened for inclusion by two reviewers. Data will be extracted using a standard form. Risk of bias in all included studies will be assessed using the Effective Practice and Organisation of Care (EPOC) criteria. Economic studies will be assessed using the Consensus Health Economic Criteria (CHEC) list as per the Cochrane Handbook for critical appraisal of methodological quality. A narrative synthesis will be performed, and the certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Where data support quantitative synthesis, a meta-analysis will be performed.
Discussion: This systematic review will give an overview of the effectiveness of pharmacist interventions to improve prescribing and health outcomes in a vulnerable patient group. This will provide evidence to policy makers on strategies involving clinical pharmacists integrated within general practice, to address issues which arise in polypharmacy and multimorbidity. 
PROSPERO Registration: CRD42019139679 (28/08/19) 

Funding

Managing complex multimorbidity in primary care: a multidisciplnary doctoral training programme

Health Research Board

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Data Availability Statement

Underlying data No data are associated with this article Extended data Open Science Framework: The effectiveness of integrating clinical pharmacists within general practice to optimise prescribing and health outcomes in primary care patients with polypharmacy: A protocol for a systematic review. https://doi.org/10.17605/OSF.IO/38CU526 This project contains the following extended data: Data extraction template.xlsx (Excel file containing the data extraction sheet for the study) PubMed Search Strategy.docx (Word document containing the PubMed search strategy)

Comments

The original article and an updated version may be available on https://hrbopenresearch.org/

Published Citation

Croke A. et al. The effectiveness of integrating clinical pharmacists within general practice to optimise prescribing and health outcomes in primary care patients with polypharmacy: A protocol for a systematic review [version 2; peer review: 2 approved]. HRB Open Res. 2020;2:32

Publication Date

12 March 2020

PubMed ID

32296750

Department/Unit

  • General Practice
  • School of Pharmacy and Biomolecular Sciences

Research Area

  • Population Health and Health Services

Publisher

F1000 Research Ltd

Version

  • N/A