Tipos de Serviços Farmacêuticos Clínicos: O que dizem as Revisões Sistemáticas?
Muito vem sendo publicado nos últimos anos em termos de desenhos de novos serviços farmacêuticos clínicos. Predomina hoje incerteza sobre que serviços farmacêuticos apresentam melhores resultados ou são promissores em termos de implementação e adoção pelos profissionais. Além disso, a diversidade de denominações dificulta a padronização de práticas entre farmacêuticos e organizações. O objetivo deste trabalho foi descrever os serviços farmacêuticos clínicos avaliados em revisões sistemáticas publicadas e identificar de forma qualitativa os seus componentes principais. Foi realizada uma busca sistemática de revisões sistemáticas, seguindo as recomendações da colaboração Cochrane, na base de dados Medline via Pubmed no período compreendido entre 2000 e 2010. Foram encontrados 343 artigos potencialmente relevantes, dos quais 49 foram incluídos após o processo de seleção. Foram identificadas oito categorias de serviços clínicos, agrupadas segundo o seu objetivo principal: aconselhamento do doente, controlo de fatores de risco, adesão ao tratamento, revisão da farmacoterapia, acompanhamento farmacoterapêutico, elaboração ou aprimoramento da história farmacoterapêutica, informações ao médico e equipa de saúde e prescrição de novos tratamentos. De um modo geral, estes serviços têm como foco a melhoria da qualidade do uso dos medicamentos e dos resultados terapêuticos sob o ponto de vista clínico, humanístico e económico.
Roberts AS, Hopp T, Sørensen EW, Benrimoj SI, Chen TF, Herborg H, et al. Understanding practice change in community pharmacy: a qualitative research instrument based on organisational theory. Pharmacy world & science. 2003 Oct;25(5):227–34.
Gastelurrutia MA, Fernández-Llimós F, García Delgado P, Gastelurrutia P, Faus MJ, Benrimoj SI. Barriers and facilitators to the dissemination and implementation of cognitive services in Spanish community pharmacies. Seguimiento Farmacoterapeutico. 2005;3(2):65–77.
Hepler CD. Clinical pharmacy, pharmaceutical care, and the quality of drug therapy. Pharmacotherapy. 2004;24(11):1491–8.
FIP IPF. Annex 8: Joint FIP/WHO guidelines on good pharmacy practice: standards for quality of pharmacy services. The Hague: World Health Organization; 2011.
World Health Organization. The role of the pharmacist in self-care and self-medication. Report of the 4th WHO Consultive Group on the role of the pharmacist. Hague: WHO; 1998.
Organización Mundial de la Salud. El papel del Farmacéutico en la Atención a la Salud: Declaración de Tokio. Genebra: OMS; 1993.
Farris KB, Kirking DM. Assessing the quality of pharmaceutical care. II. Application of concepts of quality assessment from medical care. Ann Pharmacother. 1993;27(2):215–23.
de Castro MS, Correr CJ. Pharmaceutical care in
community pharmacies: practice and research in Brazil. The Annals of pharmacotherapy. 2007 Sep;41(9):1486–93.
Costa S, Santos C, Silveira J. Community pharmacy services in Portugal. The Annals of pharma- cotherapy. 2006 Dec;40(12):2228–34.
Cavaco AM, Pereira PF. Pharmacists’ counseling protocols for minor ailments: a structure-based analysis. Research in social & administrative pharmacy : RSAP. 2012 Jan;8(1):87–100.
Tonna AP, Stewart D, West B, McCaig D. Phar- macist prescribing in the UK - a literature review of current practice and research. Journal of clinical pharmacy and therapeutics. 2007 Dec;32(6):545–56.
Chhabra PT, Rattinger GB, Dutcher SK, Hare ME, Parsons KL, Zuckerman IH. Medication reconciliation during the transition to and from long- term care settings: A systematic review. Research insocial & administrative pharmacy: RSAP.2011 Apr 20;8(1):60–75.
Benrimoj SI, Feletto E, Gastelurrutia MA, Martinez-Martinez F, Faus MJ. A holistic and integrated approach to implementing cognitive pharmaceutical services. Ars Pharm. 2010;[In Press].
Higgins JPT GS (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration; 2011.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ (Clinical research ed.). 2009 Jan 21;339(jul21
Melchiors AC, Correr CJ, Venson R, Pontarolo R.
An analysis of quality of systematic reviews on pharmacist health interventions. International journal of clinical pharmacy. 2012 Feb;34(1):32–42
Kennie NR, Schuster BG, Einarson TR. Critical analysis of the pharmaceutical care research literature. The Annals of pharmacotherapy. 1998 Jan;32(1):17–26.
Tully MP, Seston EM. Impact of pharmacists providing a prescription review and monitoring service in ambulatory care or community practice. The Annals of pharmacotherapy. 2000 Nov;34(11):1320–31.
Morrison A, Wertheimer AI. Evaluation of studies investigating the effectiveness of pharmacists’ clinical services. American journal of health-system pharmacy. 2001 Apr 1;58(7):569–77.
Renders CM, Valk GD, Griffin S, Wagner EH, Eijk JT, Assendelft WJ. Interventions to improve the management of diabetes mellitus in primary care, outpatient and community settings. Co- chrane database of systematic reviews (Online). 2001 Jan;(1):CD001481.
Blenkinsopp A, Anderson C, Armstrong M. Systematic review of the effectiveness of community pharmacy-based interventions to reduce risk behaviours and risk factors for coronary heart disease. Journal of public health medicine. 2003 Jun;25(2):144–53.
Finley PR, Crismon ML, Rush a J. Evaluating the impact of pharmacists in mental health: a systematic review. Pharmacotherapy. 2003 Dec;23(12):1634–44.
Rollason V, Vogt N. Reduction of polypharmacy in the elderly: a systematic review of the role of the pharmacist. Drugs & aging. 2003 Jan;20(11):817–32
Costello I, Wong ICK, Nunn AJ. A literature review to identify interventions to improve the use of medicines in children. Child: care, health and development. 2004 Nov;30(6):647–65.
Hanlon JT, Lindblad CI, Gray SL. Can clinical pharmacy services have a positive impact on drug-related problems and health outcomes in community-based older adults? The Ameri- can journal of geriatric pharmacotherapy. 2004
Sinclair HK, Bond CM, Stead LF. Community
pharmacy personnel interventions for smoking cessation. Cochrane database of systematic reviews (Online). 2004 Jan;(1):CD003698.
BellS,McLachlanAJ,AslaniP,WhiteheadP,Chen TF. Community pharmacy services to optimise the use of medications for mental illness: a systematic review. Australia and New Zealand health policy. 2005 Jan;2:29.
Fahey T, Schroeder K, Ebrahim S. Educational and organisational interventions used to improve the management of hypertension in primary care: a systematic review. The British journal of general practice. 2005 Nov;55(520):875–82.
Van Wijk BL, Klungel OH, Heerdink ER, de Boer A. Effectiveness of interventions by community pharmacists to improve patient adherence to chronic medication: a systematic review. The Annals of pharmacotherapy. 2005 Feb;39(2):319– 28.
Desplenter FAM, Simoens S, Laekeman G. The impact of informing psychiatric patients about their medication: a systematic review. Pharmacy world & science : PWS. 2006 Dec;28(6):329–41.
Kaboli PJ, Hoth AB, McClimon BJ, Schnipper JL.
Clinical pharmacists and inpatient medical care:
a systematic review. Archives of internal medicine. 2006 May 8;166(9):955–64.
Lindenmeyer A, Hearnshaw H, Vermeire E, Van Royen P, Wens J, Biot Y. Interventions to improve adherence to medication in people with type 2 diabetes mellitus: a review of the literature on the role of pharmacists. Journal of clinical pharmacy and therapeutics. 2006 Oct;31(5):409–19.
Ogedegbe G, Schoenthaler A. A systematic review of the effects of home blood pressure monitoring on medication adherence. Journal of clinical hypertension (Greenwich, Conn.). 2006 Mar;8(3):174–80.
Royal S, Smeaton L, Avery AJ, Hurwitz B, Shei- kh A. Interventions in primary care to reduce medication related adverse events and hospital admissions: systematic review and meta-analysis. Quality & safety in health care. 2006 Feb;15(1):23–31.
Rueda S, Park-Wyllie LY, Bayoumi AM, Tynan AM, Antoniou TA, Rourke SB, et al. Patient support and education for promoting adherence to highly active antiretroviral therapy for HIV/AIDS. Cochrane database of systematic reviews (Online). 2006 Jan;3:CD001442.
Machado M, Bajcar J, Guzzo GC, Einarson TR. Sensitivity of patient outcomes to pharmacist interventions. Part II: Systematic review and meta-analysis in hypertension management. Ann Pharmacother. 2007;41(11):1770–81.
Machado M, Bajcar J, Guzzo GC, Einarson TR. Sensitivity of patient outcomes to pharmacist interventions. Part I: systematic review and meta-analysis in diabetes management. Ann Pharma- cother. 2007;41(10):1569–82.
vonGuntenV, ReymondJ-P, Beney J. Clinical and economic outcomes of pharmaceutical services related to antibiotic use: a literature review. Pharmacy world & science. 2007 Jun;29(3):146–63.
George J, Elliott RA, Stewart DC. A systematic review of interventions to improve medication taking in elderly patients prescribed multiple medications. Drugs & aging. 2008 Jan;25(4):307–24.
Holland R, Desborough J, Goodyer L, Hall S, Wright D, Loke YK. Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. British journal of clinical pharmacology. 2008 Mar;65(3):303–16.
Koshman SL, Charrois TL, Simpson SH, McAlister FA, Tsuyuki RT. Pharmacist care of patients with heart failure: a systematic review of randomized trials. Arch Intern Med. 2008;168(7):687–94.
Machado M, Nassor N, Bajcar JM, Guzzo GC, Einarson TR. Sensitivity of patient outcomes to pharmacist interventions. Part III: systematic review and meta-analysis in hyperlipidemia mana- gement. The Annals of pharmacotherapy. 2008 Sep;42(9):1195–207.
Schlenk EA, Bernardo LM, Organist LA, Klem ML, Engberg S. Optimizing Medication Adherence in Older Patients: A Systematic Review. Journal of clinical outcomes management : JCOM. 2008 Dec 1;15(12):595–606.
Tonna AP, Stewart D, West B, Gould I, McCaig D. Antimicrobial optimisation in secondary care: the pharmacist as part of a multidisciplinary antimicrobial programme - a literature review. International journal of antimicrobial agents. 2008 Jun;31(6):511–7.
Williams A, Manias E, Walker R. Interventions to improve medication adherence in people with multiple chronic conditions: a systematic review. Journal of advanced nursing. 2008 Jul;63(2):132– 43.
Wubben DP, Vivian EM. Effects of pharmacist outpatient interventions on adults with diabetes mellitus: a systematic review. Pharmacotherapy. 2008 Apr;28(4):421–36.
Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane database of systematic reviews (Online). 2008 Jan;(2):CD000011.
Banning M. A review of interventions used to improve adherence to medication in older people. International journal of nursing studies. 2009 Nov;46(11):1505–15.
Bayoumi I, Howard M, Holbrook AM, Schabort I. Interventions to improve medication reconciliation in primary care. The Annals of pharmaco-therapy. 2009 Oct;43(10):1667–75.
Carter BL, Rogers M, Daly J, Zheng S, James PA. The potency of team-based care interventions for hypertension: a meta-analysis. Archives of internal medicine. 2009 Oct 26;169(19):1748–55.
Ellitt GR, Brien J-anne E, Aslani P, Chen TF. Quality patient care and pharmacists’ role in its continnily - a systematic review. The Annals of pharmacotherapy. 2009 Apr;43(4):677–91.
Kaur S, Mitchell G, Vitetta L, Roberts MS. Interventions that can reduce inappropriate prescribing in the elderly: a systematic review. Drugs & aging. 2009 Jan;26(12):1013–28.
Naik Panvelkar P, Saini B, Armour C. Measurement of patient satisfaction with community pharmacy services: a review. Pharmacy world & science : PWS. 2009 Oct;31(5):525–37.
Verrue CLR, Petrovic M, Mehuys E, Remon JP, Vander Stichele R. Pharmacists’ interventions for optimization of medication use in nursing homes: a systematic review. Drugs & aging. 2009 Jan;26(1):37–49.
Chisholm-Burns MA, Kim Lee J, Spivey CA, Slack M, Herrier RN, Hall-Lipsy E, et al. US pharmacists’ effect as team members on patient care: systematic review and meta-analyses. Medical care. 2010 Oct;48(10):923–33.
Cutrona SL, Choudhry NK, Fischer MA, Servi A, Liberman JN, Brennan TA, et al. Modes of delivery for interventions to improve cardiovascular medication adherence. The American journal of managed care. 2010 Jan;16(12):929–42.
Gallagher H, de Lusignan S, Harris K, Cates C. Quality-improvement strategies for the management of hypertension in chronic kidney disease in primary care: a systematic review. The British journal of general practice : the journal of the Royal College of General Practitioners. 2010 Jun;60(575):e258–65.
Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Interventions used to improve control of blood pressure in patients with hypertension. Cochrane database of systematic reviews (Online). 2010 Jan;(3):CD005182.
Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Self-monitoring and other non-pharmacological interventions to improve the management of hypertension in primary care: a systematic review. The British journal of general practice.
LaMantia MA, Scheunemann LP, Viera AJ, Busby-
Whitehead J, Hanson LC. Interventions to improve transitional care between nursing homes and hospitals: a systematic review. Journal of the American Geriatrics Society. 2010 Apr;58(4):777–82.
Marcum ZA, Handler SM, Wright R, Hanlon JT. Interventions to improve suboptimal prescribing in nursing homes: A narrative review. The American journal of geriatric pharmacotherapy. 2010 Jun;8(3):183–200.
Nkansah N, Mostovetsky O, Yu C, Chheng T, Beney J, Bond CM, et al. Effect of outpatient pharmacists’ non-dispensing roles on patient outcomes and prescribing patterns. Cochrane database of systematic reviews (Online). 2010 Jan;(7):CD000336.
Robertson J, Walkom E, Pearson S-A, Hains I, Williamsone M, Newby D. The impact of pharmacy computerised clinical decision support on prescribing, clinical and patient outcomes: a systematic review of the literature. The International journal of pharmacy practice. 2010 Apr;18(2):69–87.
Saokaew S, Permsuwan U, Chaiyakunapruk N, Nathisuwan S, Sukonthasarn A. Effectiveness of pharmacist-participated warfarin therapy management: a systematic review and meta-analysis. Journal of thrombosis and haemostasis : JTH. 2010 Nov;8(11):2418–27.
Stemer G, Lemmens-Gruber R. Clinical pharmacy services and solid organ transplantation: a literature review. Pharmacy world & science : PWS. 2010 Feb;32(1):7–18.
Babinec PM, Rock MJ, Lorenzetti DL, Johnson JA. Do researchers use pharmacists’ communication as an outcome measure? A scoping review of pharmacist involvement in diabetes care. The International journal of pharmacy practice. 2010 Aug;18(4):183–93.