Review of community pharmacy services: what is being performed, and where are the opportunities for improvement?

Figures & data

Figure 1 Inclusion/exclusion criteria.

Table 1 Studies involving standard pharmacist’s activities included in the review

Reference	Country	Study focus	Results
Watson et al^Citation49 Study type: observational Scope of practice: standard practice	Scotland	Compare health- and cost-related outcomes of consultations for minor ailments symptoms	Convenience of location was the most common reason for choice of consultation setting
Akol et al^Citation12 Study type: interview Scope of practice: training specifically for study	Uganda	Assess perspectives on the quality of care and satisfaction with intramuscular administration of contraception by drug store owners	Most were satisfied receiving their contraception from the drug shop and intended to get the next injection from the drug shop
Patricia et al^Citation8 Study type: descriptive Scope of practice: standard practice	Portugal	Identify factors that contribute to patients’ pharmacy loyalty	Humanistic-based skills were found to promote customers’ visit to pharmacies
Malewski et al^Citation6 Study type: survey Scope of practice: standard practice	USA	Examine urban and suburban community pharmacy populations for similarities and differences in patient satisfaction	Satisfaction with pharmacist’s relationship and service high with no significant differences between locations
Mansell et al^Citation25 Study type: evaluation Scope of practice: standard practice	Canada	Assess symptomatic improvement for patients treated by a pharmacist	Patients were very satisfied with their symptomatic improvement and with the service in general
Kjeldsen et al^Citation21 Study type: randomized control trial Scope of practice: training specifically for study	Denmark	Investigate if a brief, comprehensive individually targeted intervention for diabetic patients could improve drug therapy implementation in pharmacies	The study showed improvement in patient health, well-being, knowledge, and satisfaction
McMillan et al^Citation10 Study type: semi-structured interviews Scope of practice: standard practice	Australia	Explore the attributes of pharmacy choice for people with chronic conditions	Five attributes influenced this choice: patient- centered care, convenience, price, personal traits, and service/medication need
Tan et al^Citation20 Study type: pre/post-intervention Scope of practice: standard practice	Australia	Evaluate the effectiveness of pharmacist’s consultations based on primary care practices	Patients were highly satisfied with the pharmacist’s consultations and were effective in identifying and resolving medication-related problems
Patterson et al^Citation7 Study type: cross-sectional study Scope of practice: standard practice	USA	Identify relationships among pharmacy service use, general and service-specific patient satisfaction, pharmacy patronage motives, and marketing awareness	Study participants were mostly satisfied with the pharmacy services on global and service-specific measures
Jaffray et al^Citation52 Study type: randomized control trial Scope of practice: training specifically for study	Scotland	Determine whether trained pharmacists can improve methadone outcomes	It did not significantly reduce heroin use, but there are indications of increased communication and satisfaction
Tran et al^Citation14 Study type: interviews Scope of practice: standard practice	Australia	Explore pharmacist–consumer interactions about complementary medicines, with focus on consumer expectations, perceptions, and satisfaction	There was high consumer satisfaction, which was in agreement with pharmacist’s perceptions of consumer satisfaction
Rubio-Valera et al^Citation23 Study type: randomized control trial Scope of practice: training specifically for study	Spain	Evaluate the impact of a pharmacist’s intervention on patients who had initiated antidepressant treatment	Patients showed improvement in health- related quality of life, but none in clinical symptoms or pharmacy satisfaction
Kaae et al^Citation16 Study type: semi-structured interviews Scope of practice: standard practice	Denmark	Investigate how patients perceive pharmacy counseling at the present time, to develop the patient–pharmacy relationship	Customers favor pharmacy OTC medication counseling and first-time prescriptions, but find it hard to express the role of pharmacies
Collum et al^Citation13 Study type: pilot study Scope of practice: standard practice	USA	Describe the satisfaction of patients at high risk for medication misadventures with care communication at a clinic-based pharmacy	Few patients reported the use of recommended communication techniques by the pharmacist
Bosse et al^Citation24 Study type: evaluation Scope of practice: standard practice	USA	Evaluate if patient adherence to self-care advice from a pharmacist provides satisfactory symptom relief	Patients felt that it led to greater symptom improvement, and would like to see this service offered all of the time
van Geffen et al^Citation17 Study type: survey Scope of practice: standard practice	The Netherlands	Assess patient perceptions of received cardiovascular drug information and counseling	Most were unsatisfied with the information received and reported not experiencing some counseling activities
Naik Panvelkar et al^Citation15 Study type: interview Scope of practice: standard practice	Australia	Explore patient preferences for types of pharmacy-based asthma services and identify service aspects that patients prefer	Both naive and experienced patients had a high level of satisfaction
Black et al^Citation19 Study type: survey Scope of practice: standard practice	Canada	Determine patient preferences, satisfaction, and perceived stigma related to pharmacists	Traditional pharmacy services were perceived to be of greater importance than some clinical services
Simoens et al^Citation4 Study type: survey Scope of practice: standard practice	Belgium	Explore patient experiences of purchasing OTC medications in pharmacies	Patients were satisfied with pharmacy distribution and services related to OTC medications
van Geffen et al^Citation18 Study type: descriptive Scope of practice: standard practice	The Netherlands	Examine patients’ perceptions of information received when starting a selective serotonin reuptake inhibitor, to identify needs and the potential role of the pharmacist	Patients felt that they would benefit from tailored information. Many patients required more concrete and practical information than was provided
Hoffmann et al^Citation22 Study type: randomized controlled trial Scope of practice: training specifically for study	Germany	Evaluate the effects of pharmaceutical care for patients with headache or migraine, on both clinical and psychological end points	Most participants described this intervention as helpful and effective and reported that they would recommend pharmaceutical care to others
McAuley et al^Citation11 Study type: survey Scope of practice: standard practice	USA	Survey patients with epilepsy about the current and potential role pharmacists play/could play in their care	Patients reported good relationships with their pharmacists, but were concerned about lack of privacy and did not want to pay for services
Du Pasquier and Aslani^Citation5 Study type: semi-structured interview Scope of practice: standard practice	Australia	Explore consumers’ attitudes toward, and expectations of, adherence support services in a pharmacy	Participants valued two-way communication and increased consideration of their needs/beliefs, but were hesitant about shared decision making

Abbreviation: OTC, over the counter.

Table 2 Studies involving new in-person services included in the review

Reference	Country	Study focus	Results
Luder et al^Citation42 Study type: prospective, quasi-experimental Scope of practice: training specifically for study	USA	If transition of care has decreased hospital readmission, resolved medication problems, and increased patient satisfaction	A community pharmacist in the usual discharge process improved the quality of care and significantly reduced hospital readmissions
O’Neal et al^Citation34 Study type: observational Scope of practice: training specifically for study	USA	Develop and assess a tool evaluating the impact of a pharmacist’s training program from the patients’ perspective	A continuing education program is desired and has the potential to impact the quality of life for migraine and recurrent headache sufferers
Hanes et al^Citation35 Study type: survey Scope of practice: expanded practice	Australia	Perspectives of pharmacy staff involved in CPAP and sleep apnea-related services	Respondents felt there was room for improvement in some aspect of CPAP service
Jackson et al^Citation40 Study type: survey Scope of practice: collaborative practice agreement	USA	Enhance public access to prophylaxis for Lyme disease and assess patient satisfaction with the pharmacy-based service provided	High level of satisfaction with pharmacy services provided, and no reports of subsequent development of symptoms or major adverse events
Rickles et al^Citation38 Study type: evaluation Scope of practice: training specifically for study	USA	Evaluate the impact and patient satisfaction of a pharmacy-based cognitive memory screening and referral program	Cognitive memory screening can be easily incorporated into clinical service offerings in a pharmacy
Breslow^Citation39 Study type: observational Scope of practice: training specifically for study	USA	Describe patient attitudes and satisfaction toward pharmacist-administered memory screenings	The majority of participants responded favorably to several aspects of offering memory screening in pharmacies
Hui-Callahan et al^Citation28 Study type: prospective Scope of practice: training specifically for study	USA	Determine if diabetic patients who used a financial rewards program in a grocery chain pharmacy had increased rates of self- reported healthy behaviors	Satisfaction was favorable. Participants reported that the program increased behavior awareness and accountability, and motivation to improve health
DiDonato et al^Citation37 Study type: prospective cohort Scope of practice: standard practice	USA	Assess the clinical and patient-centered outcomes of pharmacist’s health coaching in the workplace	Wellness coaching by a pharmacist can result in significant improvements in cardiovascular risk factors
Warner et al^Citation33 Study type: observational Scope of practice: expanded practice	England	Determine if the inclusion of pharmacies improve vaccination rates and is acceptable to patients	Pharmacies can help increase vaccination rates and has high levels of patient acceptability
American Pharmacists Association^Citation29 Study type: observational Scope of practice: training specifically for study	USA	Describe the development and implementation of the Discussions on Taking Medications Diabetes Pilot Program and satisfaction	Small, focused interactions addressing issues of concern to patients could improve patient adherence to medication therapy
Shoukry et al^Citation36 Study type: qualitative Scope of practice: standard practice	Australia	Explore the experiences of patients with obstructive sleep apnea who get treatment through pharmacies	High satisfaction with pharmacy services was expressed, with convenience and good service as notable characteristics
Saini et al^Citation30 Study type: pre/post-intervention Scope of practice: training specifically for study	Australia	Assess any improvements in knowledge of asthma patients after a tailored education program delivered by pharmacists and sustainability of improvements	Asthma knowledge significantly improved as a result of the service, and patients changed the way they managed their asthma
Mitchell et al^Citation27 Study type: longitudinal Scope of practice: training specifically for study	Australia	Evaluate the capacity and effectiveness of trained pharmacists in delivering the Diabetes Medication Assistance Service	Patients reported improvements in knowledge about diabetes self-management, and improved glycemic control and adherence
Hugtenburg et al^Citation41 Study type: controlled intervention Scope of practice: standard practice	The Netherlands	Evaluate a comprehensive protocol for discharge care on patient satisfaction as well as on drug use compliance and mortality	Patient counseling at discharge from hospital by pharmacists appears to be meaningful
Lea et al^Citation32 Study type: survey Scope of practice: standard practice	Australia	Explore consumer satisfaction associated with the delivery of opioid substitution treatment at pharmacies	Participants expressed a high level of satisfaction with most service aspects, but wanted more privacy
Saini et al^Citation31 Study type: repeated measures Scope of practice: training specifically for study	Australia	Compare the effect of a pharmacist-delivered rural asthma management service on health outcomes for people with asthma	Patients had a reduction in the asthma severity and risk of nonadherence to medication scores, and an increase in patients with a written action plan

Abbreviation: CPAP, continuous positive airway pressure.

Table 3 Studies involving new technology-assisted services included in the review

Reference	Country	Study focus	Results
Butler et al^Citation43 Study type: survey Scope of practice: standard practice	USA	Patient satisfaction with medication synchronization	All patients were highly satisfied with medication synchronization program, and it should expand to a wider population
Shaw et al^Citation48 Study type: observational Scope of practice: training specifically for study	New Zealand	Examine attitudes toward a new collaborative pharmacy-based model of care for the management of warfarin treatment	The model of care was highly valued by patients and supported by primary care practitioners
Stuurman-Bieze et al^Citation45 Study type: pre/post-intervention Scope of practice: training specifically for study	The Netherlands	Determine the effects of a pharmacists’ intervention on the 1-year discontinuation and adherence rates of osteoporosis medication	Program significantly decreased the number of patients discontinuing osteoporosis medication
Stuurman-Bieze et al^Citation46 Study type: prospective intervention Scope of practice: training specifically for study	The Netherlands	Assess the effect of a proactive care intervention program and patients’ satisfaction	Patient satisfaction was very high. Pharmacists can contribute to optimal use of chronic medications
Billups et al^Citation44 Study type: quasi-experimental Scope of practice: training specifically for study	USA	Compare completeness of medication and blood pressure monitoring for patients requesting medication refills through multiple services	Pharmacists managing chronic medications resulted in more complete medication monitoring compared to others
Beaucage et al^Citation47 Study type: randomized controlled trial Scope of practice: standard practice	Canada	Study the impact of a pharmacist’s telephone follow-up intervention on clinical outcomes, pharmaceutical care, and costs for patients undergoing antibiotic treatment	A telephone follow-up is simple and quick, but it did not improve the number of infectious symptoms or the infection severity score

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