Involving community pharmacists in interprofessional collaboration in primary care: a systematic review

Abstract

Background: The World Health Organization supports interprofessional collaboration in primary care. On over the past 20 years, community pharmacists had been taking a growing number of new responsibilities and they are recognized as a core member of collaborative care teams as patient-centered care providers. This systematic review aimed to describe interprofessional collaboration in primary care involving a pharmacist, and its effect on patient related outcomes.

Methods: A systematic review of randomized controlled trials cited in the MEDLINE, EMBASE, PsycInfo and CINAHL in English and French was conducted from inception to November 2022. Studies were included if they described an intervention piloted by a primary care provider and included a pharmacist and if they evaluated the effects of intervention on a disease or on patient related outcomes. The search generated 3494 articles. After duplicates were removed and titles and abstracts screened for inclusion, 344 articles remained.

Results: Overall, 19 studies were included in the review and assessed for quality. We found 14 studies describing an exclusive collaboration between physician and pharmacist with for all studies a three-step model of pharmacist intervention: a medication review, an interview with the patient, and recommendations made to physician. Major topics in the articles eligible for inclusion included cardiovascular diseases with blood pressure, diabetes, dyslipidemia, and risk of cardiovascular diseases. Positive effects concerned principally blood pressure.

Conclusions: Collaboration involving pharmacists is mainly described in relation to cardiovascular diseases, for which patient-centered indicators are most often positive. It underscores the need for further controlled studies on pharmacist-involved interprofessional collaboration across various medical conditions to improve consensus on core outcomes measures.

Keywords: Collaborative practice; Community pharmacist; Primary care.

Fig. 1

PRISMA Flow Diagram. Abbreviations: IMRaD: Introduction, Methods, Results and Discussion, RCT: randomized controlled trials

Fig. 2

Illustration of Investigated Topic Frequencies in Selected Studies. Legend: the bigger the circle, the more studied the topic. Abbreviations: CV risk: cardiovascular risk

Fig. 3

: Synthesis of the impact of interprofessional collaboration categorized by subject. Abbreviations: CV risk: cardiovascular risk