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Meta-Analysis
. 2019 Dec 6;12(12):CD011207.
doi: 10.1002/14651858.CD011207.pub2.

Community pharmacy interventions for health promotion: effects on professional practice and health outcomes

Liz Steed  1 , Ratna Sohanpal  1 , Adam Todd  2 , Vichithranie W Madurasinghe  1 , Carol Rivas  3 , Elizabeth A Edwards  1 , Carolyn D Summerbell  4 , Stephanie Jc Taylor  1   5 , R T Walton  1   5
Affiliations
Meta-Analysis

Community pharmacy interventions for health promotion: effects on professional practice and health outcomes

Liz Steed et al. Cochrane Database Syst Rev. .

Abstract

Background: Community pharmacies are an easily accessible and cost-effective platform for delivering health care worldwide, and the range of services provided has undergone rapid expansion in recent years. Thus, in addition to dispensing medication, pharmacy workers within community pharmacies now give advice on a range of health-promoting behaviours that aim to improve health and to optimise the management of long-term conditions. However, it remains uncertain whether these health-promotion interventions can change the professional practice of pharmacy workers, improve health behaviours and outcomes for pharmacy users and have the potential to address health inequalities.

Objectives: To assess the effectiveness and safety of health-promotion interventions to change community pharmacy workers' professional practice and improve outcomes for users of community pharmacies.

Search methods: We searched MEDLINE, Embase, CENTRAL, six other databases and two trials registers to 6 February 2018. We also conducted reference checking, citation searches and contacted study authors to identify any additional studies.

Selection criteria: We included randomised trials of health-promotion interventions in community pharmacies targeted at, or delivered by, pharmacy workers that aimed to improve the health-related behaviour of people attending the pharmacy compared to no treatment, or usual treatment received in the community pharmacy. We excluded interventions where there was no interaction between pharmacy workers and pharmacy users, and those that focused on medication use only.

Data collection and analysis: We used standard procedures recommended by Cochrane and the Effective Practice and Organisation of Care review group for both data collection and analysis. We compared intervention to no intervention or to usual treatment using standardised mean differences (SMD) and 95% confidence intervals (95% CI) (higher scores represent better outcomes for pharmacy user health-related behaviour and quality of life, and lower scores represent better outcomes for clinical outcomes, costs and adverse events). Interpretation of effect sizes (SMD) was in line with Cochrane recommendations.

Main results: We included 57 randomised trials with 16,220 participants, described in 83 reports. Forty-nine studies were conducted in high-income countries, and eight in middle-income countries. We found no studies that had been conducted in low-income countries. Most interventions were educational, or incorporated skills training. Interventions were directed at pharmacy workers (n = 8), pharmacy users (n = 13), or both (n = 36). The clinical areas most frequently studied were diabetes, hypertension, asthma, and modification of cardiovascular risk. Duration of follow-up of interventions was often unclear. Only five studies gave details about the theoretical basis for the intervention, and studies did not provide sufficient data to comment on health inequalities. The most common sources of bias were lack of protection against contamination - mainly in individually randomised studies - and inadequate blinding of participants. The certainty of the evidence for all outcomes was moderate. We downgraded the certainty because of the heterogeneity across studies and evidence of potential publication bias. Professional practice outcomes We conducted a narrative analysis for pharmacy worker behaviour due to high heterogeneity in the results. Health-promotion interventions probably improve pharmacy workers' behaviour (2944 participants; 9 studies; moderate-certainty evidence) when compared to no intervention. These studies typically assessed behaviour using a simulated patient (mystery shopper) methodology. Pharmacy user outcomes Health-promotion interventions probably lead to a slight improvement in health-related behaviours of pharmacy users when compared to usual treatment (SMD 0.43, 95% CI 0.14 to 0.72; I2 = 89%; 10 trials; 2138 participants; moderate-certainty evidence). These interventions probably also lead to a slight improvement in intermediate clinical outcomes, such as levels of cholesterol or glycated haemoglobin, for pharmacy users (SMD -0.43, 95% CI -0.65 to -0.21; I2 = 90%; 20 trials; 3971 participants; moderate-certainty evidence). We identified no studies that evaluated the impact of health-promotion interventions on event-based clinical outcomes, such as stroke or myocardial infarction, or the psychological well-being of pharmacy users. Health-promotion interventions probably lead to a slight improvement in quality of life for pharmacy users (SMD 0.29, 95% CI 0.08 to 0.50; I2= 82%; 10 trials, 2687 participants; moderate-certainty evidence). Adverse events No studies reported adverse events for either pharmacy workers or pharmacy users. Costs We found that health-promotion interventions are likely to be cost-effective, based on moderate-certainty evidence from five of seven studies that reported an economic evaluation.

Authors' conclusions: Health-promotion interventions in the community pharmacy context probably improve pharmacy workers' behaviour and probably have a slight beneficial effect on health-related behaviour, intermediate clinical outcomes, and quality of life for pharmacy users. Such interventions are likely to be cost-effective and the effects are seen across a range of clinical conditions and health-related behaviours. Nevertheless the magnitude of the effects varies between conditions, and more effective interventions might be developed if greater consideration were given to the theoretical basis of the intervention and mechanisms for effecting behaviour change.

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Conflict of interest statement

LS: is in receipt of grant funding for various projects from the UK National Institutes of Health Research, but has no known conflicts of interest for the current publication

RS: none known

AT: none known

VM: none known

CR: none known

EE: none known

CS: none known

ST: is in receipt of grant funding for various projects from the UK National Institutes of Health Research and (in part) supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames at Bart’s Health NHS Trust but has no known conflicts of interest for the current publication.

RW: is in receipt of grant funding for various projects from the UK National Institutes of Health Research. This review was funded by a programme grant for smoking cessation from the National Institute of Health Research in the UK. RW has received consultancy fees from TTS Pharma and holds shares in this company. He has received royalties from a patent on genetic indicators of tobacco consumption. The Cochrane Funding Arbiter has looked closely into whether his patent constitutes a conflict of interest in this instance, and has decided that it does not.

The authors of the current review were also authors of one included study (Madurasinghe 2017). AT, who was not an author of the study therefore screened for inclusion, extracted, and checked all the data for this study.

Figures

1
1
Study flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
4
4
Funnel plot of comparison: 1 Usual treatment versus Health‐promotion intervention, outcome: 1.1 Pharmacy user health‐related behaviour.
5
5
Funnel plot of comparison: 1. Health‐promotion intervention versus Usual treatment outcome: Analysis 1.2 Pharmacy user intermediate clinical outcomes (final value scores)
6
6
Funnel plot of comparison: 1. Usual treatment versus Health‐promotion intervention outcome: Analysis 1.4 Pharmacy user quality of life
See this image and copyright information in PMC

Update of

References

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Weinberger 2002 {published data only}
    1. Weinberger M, Murray MD, Marrero DG, Brewer N, Lykens M, Harris LE, Tierney WM. Pharmaceutical care program for patients with reactive airways disease.. Am J Health Syst Pharm. 2001;58(9):791‐6. - PubMed
    1. Weinberger M, Murray MD, Marrero DG, Brewer N, Lykens M, Harris LE, et al. Effectiveness of pharmacist care for patients with reactive airways disease: a randomized controlled trial. JAMA 2002;288(13):1594‐602. - PubMed
Yuksel 2010 {published data only}
    1. Yuksel N, Majumdar SR, Biggs C, Tsuyuki RT. Community pharmacist‐initiated screening program for osteoporosis: randomized controlled trial. Osteoporosis International 2010;21(3):391‐8. - PubMed
    1. Yuksel N, Majumdar SR, Biggs C, Tsuyuki RT. Design of a randomized trial of a community pharmacist initiated screening and intervention program for osteoporosis. Canadian Pharmaceutical Journal 2006;139(2):50‐1.

References to studies excluded from this review

Ahrens 2003 {published data only}
    1. Ahrens RA, Hower M, Best AM. Effects of Weight Reduction Interventions by Community Pharmacists. J Am Pharm Assoc 2003;43:583‐9. - PubMed
Aleo 2014 {published data only}
    1. Aleo CL, Murchison AP, Dai Y, Hark LA, Mayro EL, Collymore B, et al. Improving eye care follow‐up adherence in diabetic patients with ocular abnormalities: the effectiveness of patient contracts in a free, pharmacy‐based eye screening. Public Health 2015;129:996‐9. - PubMed
    1. Aleo CL, Murchison AP, Hark LA, Dai Y, Mayro E, Leiby B, et al. Improving eye care follow‐up adherence in patients with diabetes: the effectiveness of patient contracts in a community‐based eye screening. Investigative Ophthalmology and Visual Science 2014;55 (13):6094.
Ammari 2013 {published data only}
    1. Ammari WG, Chrystyn H. Optimizing the inhalation flow and technique through metered dose inhalers of asthmatic adults and children attending a community pharmacy. Journal of Asthma 2013;50(5):505‐13. - PubMed
Anderson 1995 {published data only}
    1. Anderson C. A controlled study of the effect of a health promotion training scheme on pharmacists' advice about smoking cessation. Journal of Social and Administrative Pharmacy 1995;12(3):115‐24.
Anderson 2003 {published data only}
    1. Anderson C. Pharmacists' role in asthma. Pharmacy in practice 2003;16:300.
Armour 2004 {published data only}
    1. Armour CL, Taylor SJ, Hourihan F, Smith C, Krass I. Implementation and evaluation of Australian pharmacists' diabetes care services. Journal of the American Pharmacists Association: JAPhA 2004;44(4):455‐66. - PubMed
Armour 2013 {published data only}
    1. Armour CL, Reddel HK, LeMay KS, Saini B, Smith LD, Bosnic‐Anticevich SZ, et al. Feasibility and effectiveness of an evidence‐based asthma service in Australian community pharmacies: a pragmatic cluster randomized trial. Journal of Asthma 2013;50(3):302‐9. - PubMed
Basheti 2005 {published data only}
    1. Basheti IA, Reddel HK, Armour CL, Bosnic‐Anticevich SZ. Counseling about turbuhaler technique: needs assessment and effective strategies for community pharmacists. Respiratory Care 2005;50(5):617‐23. - PubMed
Bauld 2009 {published data only}
    1. Bauld L, Chesterman J, Ferguson J, Judge K. A comparison of the effectiveness of group‐based and pharmacy‐led smoking cessation treatment in Glasgow. Addiction 2009;104(2):308‐16. - PubMed
Bernsten 2001 {published data only}
    1. Bernsten C, Bjorkman I, Caramona M, Crealey G, Frokjaer F, Grundberger E, et al. Improving the well‐being of elderly patients via community pharmacy‐based provision of pharmaceutical care: a multi‐centre study in seven European countries. Drugs and Aging 2001;18(1):63‐77. - PubMed
Bock 2010 {published data only}
    1. Bock BC, Hudmon KS, Christian J, Graham AL, Bock FR. A tailored intervention to support pharmacy‐based counseling for smoking cessation. Nicotine & Tobacco Research 2010;12(3):217‐25. - PMC - PubMed
Butt 2016 {published data only}
    1. Butt M, Mhd Ali A, Bakry MM, Mustafa N. Impact of a pharmacist led diabetes mellitus intervention on HbA1c, medication adherence and quality of life: a randomised controlled study. Saudi Pharmaceutical Journal 2016;24:40‐8. - PMC - PubMed
Chabot 2003 {published data only}
    1. Chabot I, Moisan J, Gregoire JP, Milot A. Pharmacist intervention program for control of hypertension. Annals of Pharmacotherapy 2003;37(9):1186‐93. - PubMed
Chalker 2002 {published data only}
    1. Chalker J, Chuc NT, Falkenberg T, Tomson G. Private pharmacies in Hanoi, Vietnam: a randomized trial of a 2‐year multi‐component intervention on knowledge and stated practice regarding ARI, STD and antibiotic/steroid requests. Tropical Medicine & International Health 2002;7(9):803‐10. - PubMed
    1. Chuc NT, Larsson M, Do NT, Diwan VK, Tomson GB, Falkenberg T. Improving private pharmacy practice: a multi‐intervention experiment in Hanoi, Vietnam. Journal of Clinical Epidemiology 2002;55:1148‐55. - PubMed
Cody 1998 {published data only}
    1. Cody M, McCombs JS, Parker JP. The Kaiser Permanente/USC Patient Consultation Study: change in quality of life. American Journal of Health‐system Pharmacy 1998;55:2615‐20. - PubMed
Correr 2009 {published data only}
    1. Correr CJ, Pontarolo R, Wiens A, Rossignoli P, Melchiors AC, Radominski R, et al. Economic evaluation of pharmacotherapeutic follow‐up in type 2 diabetes mellitus patients in community pharmacies. Arquivos Brasileiros de Endocrinologia e Metabologia 2009;53(7):825‐33. - PubMed
Crawford 2013 {published data only}
    1. Crawford ND, Amesty S, Rivera AV, Harripersaud K, Turner A, Fuller CM. Community impact of pharmacy‐randomized intervention to improve access to syringes and services for injection drug users. Health Education & Behavior 2014;41:397‐405. - PMC - PubMed
    1. Crawford ND, Amesty S, Rivera AV, Harripersaud K, Turner A, Fuller CM. Randomized, community‐based pharmacy intervention to expand services beyond sale of sterile syringes to injection drug users in pharmacies in New York City. American Journal of Public Health 2013;103(9):1579‐82. - PMC - PubMed
Denig 2003 {published data only}
    1. Denig P, Onnes B, Haaijer‐Ruskamp FM. Improvement remains forthcoming. Effect of a peer review programme about the treatment of asthma on quality of life in patients [Verbetering Blijft nog uit. Effect vam eem FTO‐programma over asthma op kwaliteit van leven bij patienten]. Pharmceutisch Weekblad 2003;138:1276‐81.
DeRemer 2008 {published data only}
    1. DeRemer CE, VanLandingham J, Carswell J, Killough D. Pharmacy outreach education program in local community. American Journal of Pharmaceutical Education 2008;72(4):94. - PMC - PubMed
De Vera 2014 {published data only}
    1. Vera MA, Sadatsafavi M, Tsao NW, Lynd LD, Lester R, Gastonguay L, et al. Empowering pharmacists in asthma management through interactive SMS (EmPhAsIS): study protocol for a randomized controlled trial. Trials 2014;15:488. - PMC - PubMed
de Vries 2010 {published data only}
    1. Vries TW, Berg PB, Duiverman EJ, Jong‐van den Berg LT. Effect of a minimal pharmacy intervention on improvement of adherence to asthma guidelines. Archives of Disease in Childhood 2010;95(4):302‐4. - PubMed
DiDonato 2013 {published data only}
    1. DiDonato KL, May JR, Lindsey CC. Impact of wellness coaching and monitoring services provided in a community pharmacy. Journal of the American Pharmacists Association: JAPhA 2013;53(1):14‐21. - PubMed
Ditusa 2001 {published data only}
    1. Ditusa L, Luzier AB, Brady PG, Reinhardt RM, Snyder BD. A pharmacy‐based approach to cholesterol management. American Journal of Managed Care 2001;7(10):973‐9. - PubMed
Ekedahl 2008 {published data only}
    1. Ekedahl A, Oskarsson V, Sundberg B, Gustafsson V, Lundberg T, Gullberg B. Impact of postal and telephone reminders on pick‐up rates of unclaimed e‐prescriptions. Pharmacy World & Science 2008;30(5):503‐8. - PubMed
Fera 2008 {published data only}
    1. Fera T, Bluml BM, Ellis WM. Diabetes Ten City Challenge: final economic and clinical results. Journal of the American Pharmacists Association : JAPhA 2009;49(3):383‐91. - PubMed
    1. Fera T, Bluml BM, Ellis WM, Schaller CW, Garrett DG. The Diabetes Ten City Challenge: interim clinical and humanistic outcomes of a multi‐site community pharmacy diabetes care program. Journal of the American Pharmacists Association: JAPhA 2008;48(2):181‐90. - PubMed
Fikri‐Benbrahim 2012 {published data only}
    1. Fikri‐Benbrahim N, Faus MJ, Martinez‐Martinez F, Alsina DG, Sabater‐Hernandez D. Effect of a pharmacist intervention in Spanish community pharmacies on blood pressure control in hypertensive patients. American Journal of Health‐System Pharmacy 2012;69(15):1311‐8. - PubMed
Fornos 2006 {published data only}
    1. Fornos JA, Andres NF, Andres JC, Guerra MM, Egea B. A pharmacotherapy follow‐up program in patients with type‐2 diabetes in community pharmacies in Spain. Pharmacy World & Science 2006;28(2):65‐72. - PubMed
Fuller 2007 {published data only}
    1. Fuller CM, Galea S, Caceres W, Blaney S, Sisco S, Vlahov D. Multilevel community‐based intervention to increase access to sterile syringes among injection drug users through pharmacy sales in New York City. American Journal of Public Health 2007;97(1):117‐24. - PMC - PubMed
Garcao 2002 {published data only}
    1. Garcao JA, Cabrita J. Evaluation of a pharmaceutical care program for hypertensive patients in rural Portugal. Journal of the American Pharmaceutical Association 2002;42(6):858‐64. - PubMed
Goeree 2013 {published data only}
    1. Goeree R, Keyserlingk C, Burke N, He J, Kaczorowski J, Chambers L, et al. Economic appraisal of a community‐wide cardiovascular health awareness program. Value in Health 2013;16(1):39‐45. - PubMed
Gorgas 2012 {published data only}
    1. Gorgas Torner MQ, Paez VF, Camos RJ, Puig CE, Jolonch SP, Homs PE, et al. Integrated pharmaceutical care programme in patients with chronic diseases. Farmacia Hospitalaria 2012;36(4):229‐39. - PubMed
Grainger‐Rousseau 1997 {published data only}
    1. Grainger‐Rousseau TJ, Miralles MA, Hepler CD, Segal R, Doty RE, Ben‐Joseph R. Therapeutic outcomes monitoring: application of pharmaceutical care guidelines to community pharmacy. Journal of the American Pharmaceutical Association 1997;NS37(6):647‐61. - PubMed
Green 2008 {published data only}
    1. Green BB, Anderson ML, Ralston JD, Catz S, Fishman PA, Cook AJ. Patient ability and willingness to participate in a web‐based intervention to improve hypertension control. Journal of Medical Internet Research 2011;13(1):e1. - PMC - PubMed
    1. Green BB, Anderson ML, Ralston JD, Catz SL, Cook AJ. Blood pressure 1 year after completion of web‐based pharmacist care. JAMA Internal Medicine 2013;173(13):1250‐2. - PMC - PubMed
    1. Green BB, Cook AJ, Ralston JD, Fishman PA, Catz SL, Carlson J, et al. Effectiveness of home blood pressure monitoring, web communication, and pharmacist care on hypertension control: a randomized controlled trial. JAMA 2008;299(24):2857‐67. - PMC - PubMed
Haga 2017 {published data only}
    1. Haga SB, Moaddeb J, Mills R, Voora D. Assessing feasibility of delivering pharmacogenetic testing in a community pharmacy setting. Pharmacogenomics 2017;18:327‐35. - PMC - PubMed
Herborg 2001 {published data only}
    1. Herborg H, Soendergaard B, Froekjaer B, Fonnesbaek L, Jorgensen T, Hepler CD, et al. Improving drug therapy for patients with asthma ‐ part 1: patient outcomes. Journal of the American Pharmaceutical Association 2001;41(4):539‐50. - PubMed
    1. Herborg H, Soendergaard B, Jorgensen T, Fonnesbaek L, Hepler CD, Holst H, et al. Improving drug therapy for patients with asthma ‐ part 2: use of antiasthma medications. Journal of the American Pharmaceutical Association 2001;41(4):551‐9. - PubMed
Kaczorowski 2008 {published data only}
    1. Kaczorowski J, Chambers LW, Dolovich L, Paterson JM, Karwalajtys T, Gierman T, et al. Improving cardiovascular health at population level: 39 community cluster randomised trial of Cardiovascular Health Awareness Program (CHAP). BMJ 2011;342:442. - PMC - PubMed
    1. Kaczorowski J, Chambers LW, Karwalajtys T, Dolovich L, Farrell B, McDonough B, et al. Cardiovascular Health Awareness Program (CHAP): a community cluster‐randomised trial among elderly Canadians. Preventive Medicine 2008;46(6):537‐44. - PubMed
Karwalajtys 2009 {published data only}
    1. Karwalajtys T, Kaczorowski J, Hutchison B, Myers MG, Sullivan SM, Chambers LW, et al. Blood pressure variability and prevalence of hypertension using automated readings from multiple visits to a pharmacy‐based community‐wide programme. Journal of Human Hypertension 2009;23(9):585‐9. - PubMed
Kradjan 1999 {published data only}
    1. Kradjan WA, Schulz R, Christensen DB, Stergachis A, Sullivan S, Fullerton DS, et al. Patients' perceived benefit from and satisfaction with asthma‐related pharmacy services. Journal of the American Pharmaceutical Association (Washington,D.C. : 1996) 1999;39(5):658‐66. - PubMed
Krass 2011 {published data only}
    1. Krass I. Optimising pharmacy support in type 2 diabetes. Australian Journal of Pharmacy 2010;91(1086):39‐40.
    1. Krass I, Mitchell B, Song YJ, Stewart K, Peterson G, Hughes J, et al. Diabetes medication assistance service stage 1: impact and sustainability of glycaemic and lipids control in patients with type 2 diabetes. Diabetic Medicine 2011;28(8):987‐93. - PubMed
Kritikos 2007 {published data only}
    1. Kritikos V, Armour CL, Bosnic‐Anticevich SZ. Interactive small‐group asthma education in the community pharmacy setting: a pilot study. Journal of Asthma 2007;44(1):57‐64. - PubMed
Kumar, 2009 {published data only}
    1. Kumar A, Adepu R, Parthasarathi G, Mahesh PA. Impact of community pharmacist provided patient education in asthma patients on treatment outcomes ‐ a study. Indian Journal of Pharmaceutical Education and Research 2009;43:125‐33.
Lalonde 2008 ‐ PRoFIL {published data only}
    1. Beaunoyer S, Dupuis S, Dumoulin‐Charette A, Mouchbahani M, Daigneault AM, Lord A, et al. The impact of ProFiL program on the progression of chronic kidney disease (CKD) and its risk factors: an interim analysis. Journal of Population Therapeutics and Clinical Pharmacology 2014;21(1):e126‐7.
    1. Lalonde L, Letendre S, Clement V, Lord A, Bell R, Mouchbahani M. ProFiL, a training‐and‐communication network program in nephrology for community pharmacists: Impact on knowledge, clinical competences, quality of medication use and clinical variables. International Journal of Clinical Pharmacy 2015;37:423‐4.
    1. Lalonde L, Normandeau M, Lamarre D, Lord A, Berbiche D, Corneille L, et al. Evaluation of a training and communication‐network nephrology program for community pharmacists. Pharmacy World & Science 2008;30(6):924‐33. - PubMed
    1. Lalonde L, Quintana‐Barcena P, Lord A, Bell R, Clement V, Daigneault AM, et al. Community pharmacist training‐and‐communication network and drug‐related problems in patients with CKD: a multicenter, cluster‐randomized, controlled trial. American Journal of Kidney Diseases 2017;70:386‐96. - PubMed
Lugo de Ortellado 2007 {published data only}
    1. Lugo de Ortellado G, Bittner MR, Chavez H, Perez S. Implementation of a pharmaceutical care program for the detection of hypertension and drug therapy to be followed up in community pharmacies [Implementacion de un programa de atencion farmaceutica en farmacias comunitarias pas la deteccion de la hipertension arterial y su seguimiento farmacoterpeutico]. Latin American Journal of Pharmacy 2007;26:590‐5.
Manfrin 2015 {published data only}
    1. Manfrin A, Thomas T, Krska J. Randomised evaluation of the Italian medicines use review provided by community pharmacists using asthma as a model (RE I‐MUR). BMC Health Services Research 2015;15:171. - PMC - PubMed
    1. Manfrin A, Thomas T, Krska J. Symptom control and adherence are major issues for asthmatic patients: can they be improved and are they linked?. Pharmacoepidemiology and Drug Safety 2016;25(S2):18‐9.
    1. Manfrin A, Tinelli M, Thomas T, Krska J. A cluster randomised control trial to evaluate the effectiveness and cost‐effectiveness of the Italian medicines use review (I‐MUR) for asthma patients. BMC Health Services Research 2017;17:300. - PMC - PubMed
Mangiapane 2005 {published data only}
    1. Mangiapane S, Schulz M, Muhlig S, Ihle P, Schubert I, Waldmann HC. Community pharmacy‐based pharmaceutical care for asthma patients. Annals of Pharmacotherapy 2005;39(11):1817‐22. - PubMed
Marra 2012 {published data only}
    1. Marra CA, Cibere J, Grubisic M, Grindrod KA, Gastonguay L, Thomas JM, et al. Pharmacist‐initiated intervention trial in osteoarthritis: a multidisciplinary intervention for knee osteoarthritis. Arthritis Care & Research 2012;64(12):1837‐45. - PubMed
Marrero 2006 {published data only}
    1. Marrero W, Hernandez L, Garcia R, Gutirrez L. Immunization program against influenza for adults 65 years or older at a community pharmacy in Puerto Rico [Programa de Immunizacion contra la Influenza para adultos de 65 anos o mas en una farmacia de comunidad en Puerto Rico]. Puerto Rico Health Sciences Journal 2006;25(1):35‐42. - PubMed
Meijer 2005 {published data only}
    1. Meijer WM, Smit DJ, Jurgens RA, Jon‐van den Berg LT. Improved periconceptional use of folic acid after patient education in pharmacies: promising results of a pilot study in the Netherlands. International Journal of Pharmacy Practice 2005;13:47‐51.
Michie 2014 {published data only}
    1. Michie L, Cameron S T, Glasier A, Larke N, Muir A, Lorimer A. Pharmacy‐based interventions for initiating effective contraception following the use of emergency contraception: a pilot study. Contraception 2014;90:447‐53. - PubMed
Michiels 2017a {published data only}
    1. Michiels Y, Tilleul P, Mechin H, Hammes F. Impact of a community pharmacy‐based information protocol on multiple sclerosis patients' adherence to treatment with dimethyl fumarate: TECPHIE, a randomized study vs usual practice. Multiple Sclerosis Journal 2017;23(3 Suppl 1):922.
Noor 2016 {published data only}
    1. Noor ZM, Smith AJ, Smith SS, Nissen LM. A feasibility study: use of actigraph to monitor and follow‐up sleep/wake patterns in individuals attending community pharmacy with sleeping disorders. Journal of pharmacy & bioallied sciences 2016;8:173‐80. - PMC - PubMed
    1. Noor ZM, Smith AJ, Smith SS, Nissen LM. A study protocol: a community pharmacy‐based intervention for improving the management of sleep disorders in the community settings. BMC Health Services Research 2014;14:74. - PMC - PubMed
O'Dwyer 2016 {published data only}
    1. O'Dwyer SM, MacHale E, Sulaiman I, Holmes M, Hughes C, D'Arcy S, et al. The effect of providing feedback on inhaler technique and adherence from an electronic audio recording device, INCA, in a community pharmacy setting: study protocol for a randomised controlled trial. Trials 2016;17:226. - PMC - PubMed
Obarcanin 2015 {published data only}
    1. Obarcanin E, Kruger M, Muller P, Nemitz V, Schwender H, Hasanbegovic S, et al. Pharmaceutical care of adolescents with diabetes mellitus type 1: the DIADEMA study, a randomized controlled trial. International Journal of Clinical Pharmacy 2015;37:790‐8. - PubMed
Olivera 2016 {published data only}
    1. Olivera CM, Vianna EO, Bonizio RC, Menezes MB, Ferraz E, Cetlin AA, et al. Asthma self‐management model: randomized controlled trial. Health Education Research 2016;31:639‐52. - PubMed
Phimarn 2017 {published data only}
    1. Phimarn W, Paktipat P, Pansiri K, Klabklang P, Duangjanchot P, Tongkul A. Effect of weight control counselling in overweight and obese young adults. Indian Journal of Pharmaceutical Sciences 2017;79:35‐41.
    1. Phimarn W, Pianchana P, Limpikanchakovit P, Suranart K, Supapanichsakul S, Narkgoen A, et al. Thai community pharmacist involvement in weight management in primary care to improve patient's outcomes. International Journal of Clinical Pharmacy 2013;35(6):1208‐17. - PubMed
Podhipak 1993 {published data only}
    1. Podhipak A, Varavithya W, Punyaratabandhu P, Vathanophas K, Sangchai R. Impact of an educational program on the treatment practices of diarrheal diseases among pharmacists and drugsellers. Southeast Asian Journal of Tropical Medicine and Public Health 1993;24(1):32‐9. - PubMed
Prokhorov 2010 {published data only}
    1. Prokhorov AV, Humon KS, Marani S, Foxhall L, Ford KH, Luca NS, et al. Engaging physicians and pharmacists in providing smoking cessation counseling. Archives of Internal Medicine 2010;170(18):1640‐6. - PMC - PubMed
Ratanajamit 2002 {published data only}
    1. Ratanajamit C, Chongsuvivatwong V, Geater AF. A randomized controlled educational intervention on emergency contraception among drugstore personnel in southern Thailand. Journal of the American Medical Womens Association 2002;57(4):196‐9. - PubMed
Rickles 2006 {published data only}
    1. Rickles NM, Svarstad BL, Statz‐Paynter JL, Taylor LV, Kobak KA. Improving patient feedback about and outcomes with antidepressant treatment: a study in eight community pharmacies. Journal of the American Pharmacists Association: JAPhA 2006;46(1):25‐32. - PubMed
Rouleau 2007 {published data only}
    1. Rouleau R, Beauchesne MF, Laurier C. Impact of a continuing education program on community pharmacists' interventions and asthma medication use: a pilot study. Annals of Pharmacotherapy 2007;41(4):574‐80. - PubMed
Rubio‐Valera 2009 {published data only}
    1. Rubio‐Valera M, March PM, Fernandez A, Penarrubia‐Maria MT, Trave P, Lopez Del HY, et al. Evaluation of a pharmacist intervention on patients initiating pharmacological treatment for depression: a randomized controlled superiority trial. European Neuropsychopharmacology 2013;23(9):1057‐66. - PubMed
    1. Rubio‐Valera M, Serrano‐Blanco A, Trave P, Penarrubia‐Maria MT, Ruiz M, Pujol MM. Community pharmacist intervention in depressed primary care patients (PRODEFAR study): randomized controlled trial protocol. BMC Public Health 2009;9:284. - PMC - PubMed
Saini 2008 {published data only}
    1. Saini B, Filipovska J, Bosnic‐Anticevich S, Taylor S, Krass I, Armour C. An evaluation of a community pharmacy‐based rural asthma management service. Australian Journal of Rural Health 2008;16(2):100‐8. - PubMed
    1. Saini B, Krass I, Armour C. Development, implementation, and evaluation of a community pharmacy‐based asthma care model. Annals of Pharmacotherapy 2004;38(11):1954‐60. - PubMed
Saji 2012 {published data only}
    1. Saji M, Jiju AJ, Sundaran S. Study on the impact of patient counseling on the quality of life and pulmonary function of asthmatic patients. International Journal of Pharmacy and Pharmaceutical Sciences 2012;4:300‐4.
Santos 2010 {published data only}
    1. Santos DO, Martins MC, Cipriano SL, Pinto RM, Cukier A, Stelmach R. Pharmaceutical care for patients with persistent asthma: assessment of treatment compliance and use of inhaled medications. Jornal Brasileiro De Pneumologia: Publicacao Oficial Da Sociedade Brasileira De Pneumologia E Tisilogia 2010;36(1):14‐22. - PubMed
Sarayani 2012 {published data only}
    1. Sarayani A, Rashidian A, Gholami K, Torkamandi H, Javadi M. Efficacy of continuing education in improving pharmacists' competencies for providing weight management service: three‐arm randomized controlled trial. Journal of Continuing Education in the Health Professions 2012;32(3):163‐73. - PubMed
Sarkadi 2004 {published data only}
    1. Sarkadi A, Rosenqvist U. Experience‐based group education in type 2 diabetes: a randomised controlled trial. Patient Education & Counseling 2004;53(3):291‐8. - PubMed
    1. Sarkadi A, Veg A, Rosenqvist U. The influence of participant's self‐perceived role on metabolic outcomes in a diabetes group education program. Patient Education & Counseling 2005;58(2):137‐45. - PubMed
Sinclair 1998 {published data only}
    1. Sinclair HK, Bond CM, Lennox AS, Silcock J, Winfield AJ, Donnan PT. Training pharmacists and pharmacy assistants in the stage‐of‐change model of smoking cessation: a randomised controlled trial in Scotland. Tobacco Control 1998;7(3):253‐61. - PMC - PubMed
Sperandio 2012 {published data only}
    1. Sperandio da Silva GM, Chambela MC, Sousa AS, Sangenis LH, Xavier SS, Costa AR, et al. Impact of pharmaceutical care on the quality of life of patients with Chagas disease and heart failure: randomized clinical trial. Trials 2012;13:244. - PMC - PubMed
Stergachis 2002 {published data only}
    1. Stergachis A, Gardner JS, Anderson MT, Sullivan SD. Improving pediatric asthma outcomes in the community setting: does pharmaceutical care make a difference?. Journal of the American Pharmaceutical Association 2002;42(5):743‐52. - PubMed
Suppapitiporn 2005 {published data only}
    1. Suppapitiporn S, Chindavijak B, Onsanit S. Effect of diabetes drug counseling by pharmacist, diabetic disease booklet and special medication containers on glycemic control of type 2 diabetes mellitus: a randomized controlled trial. Journal of the Medical Association of Thailand 2005;88 Suppl 4:S134‐41. - PubMed
Taskila 2012 {published data only}
    1. Taskila T, Macaskill S, Coleman T, Etter JF, Patel M, Clarke S, Bridson R, Aveyard P. A randomised trial of nicotine assisted reduction to stop in pharmacies ‐ the RedPharm study. BMC Public Health 2012;12(12):182. - PMC - PubMed
Thavorn 2008 {published data only}
    1. Thavorn K, Chaiyakunapruk N. A cost‐effectiveness analysis of a community pharmacist‐based smoking cessation programme in Thailand. Tobacco Control 2008;17(3):177‐82. - PubMed
Tobari 2010 {published data only}
    1. Tobari H, Arimoto T, Shimojo N, Yhara K, Noda H, Yamagishi K, et al. Physician‐pharmacist cooperation program for blood pressure control in patients with hypertension: a randomized‐controlled trial. American Journal of Hypertension 2010;10:1144‐52. - PubMed
Tsuyuki 2015 {published data only}
    1. Tsuyuki RT, Houle SK, Charrois TL, Kolber MR, Rosenthal MM, Lewanczuk R, et al. Randomized trial of the effect of pharmacist prescribing on improving blood pressure in the community: the Alberta clinical trial in optimizing hypertension (RxACTION). Circulation 2015;132:93‐100. - PubMed
Tumwikirize 2004 {published data only}
    1. Tumwikirize WA, Ekwaru PJ, Mohammed K, Ogwal‐Okeng JW, Aupont O. Impact of a face‐to‐face educational intervention on improving the management of acute respiratory infections in private pharmacies and drug shops in Uganda. East African Medical Journal 2004;Suppl:S25‐32. - PubMed
Usami 2009 {published data only}
    1. Usami T, Hashiguchi M, Kouhara T, Ishii A, Nagata T, Mochizuki M. Impact of community pharmacists advocating immunization on influenza vaccination rates among the elderly. Yakugaku Zasshi ‐ Journal of the Pharmaceutical Society of Japan 2009;129(9):1063‐8. - PubMed
Van de Steeg‐van 2011 {published data only}
    1. Steeg‐van Gompel CH, Wensing M, Smet PA. Implementation of a pharmacist‐led intervention to enhance statin prescribing for secondary prevention in primary care: a cluster randomized trial. European Journal of Preventive Cardiology 2012;19(2):169‐76. - PubMed
    1. Steeg‐van Gompel CH, Wensing M, Smet PA. Implementation of patient education at first and second dispensing of statins in Dutch community pharmacies: the sequel of a cluster randomized trial. BMC Health Services Research 2011;11:313, 2011. - PMC - PubMed
    1. Steeg‐van Gompel CH, Wensing M, Smet PA. Implementation of patient education at first and second dispensing of statins in Dutch community pharmacies: the sequel of a cluster randomized trial. Pharmaceutisch Weekblad 2012;147:115‐21. - PMC - PubMed
Viens 2007 {published data only}
    1. Viens C, Leclerc G, Moisan S, Lebeau A. Assess the impact of the health education program prescription drugs: yes...no....maybe [Efficacite d'un programme d'eduction des aines a la sante]. Canadian Journal of Public Health 2007;98(4):301‐5. - PMC - PubMed
Wang 2013 {published data only}
    1. Wang J, Ford LJ, Wingate L, Uroza SF, Jaber N, Smith CT, et al. Effect of pharmacist intervention on herpes zoster vaccination in community pharmacies. Journal of the American Pharmacists Association: JAPhA 2013;53(1):46‐53. - PMC - PubMed
Watson 2002 {published data only}
    1. Watson MC, Bond CM, Grimshaw JM, Mollison J, Ludbrook A, Walker AE. Educational strategies to promote evidence‐based community pharmacy practice: a cluster randomized controlled trial (RCT). Family Practice 2002;19(5):529‐36. - PubMed
Westrick 2016 {published data only}
    1. Westrick SC, Owen J, Hagel H, Owensby JK, Lertpichitkul T. Impact of the RxVaccinate program for pharmacy‐based pneumococcal immunization: a cluster‐randomized controlled trial. Journal of the American Pharmacists Association: JAPhA 2016;56:29‐36.e1. - PubMed
Wilson 2004 {published data only}
    1. Wilson SJ, MacLellan E, Cox JL, Meek W, Monette K, Morash T, et al. A pilot study evaluating the feasibility of monitoring oral anticoagulant therapy with point of care testing in a community pharmacy. Canadian Journal of Hospital Pharmacy 2004;57:158‐64.
Young 2012 {published data only}
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References to ongoing studies

Davis 2016 {published data only}
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Michiels 2017 {published data only}
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Porteous 2013 {published data only}
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