La pharmacie hospitaliere a considerablement evolue au cours des quatre dernieres decennies. Notre discipline, representee dans la litterature depuis 1797 avec le Journal de la Societe des pharmaciens de Paris, est un terrain fertile a la publication de travaux de recherche. L’offre actuelle en revues pharmaceutiques temoigne de cette evolution et des activites de recherche.
Toutefois, les travaux publies ne sont pas equivalents selon le niveau de preuve recherche. Une etape prealable de selection peut s’averer necessaire pour les pharmaciens soucieux de publier leurs travaux dans une revue appropriee ainsi que pour les pharmaciens en recherche de preuves dans la litterature.
Les indicateurs de notoriete peuvent-ils guider notre exposition a la litterature scientifique ?
There are an increasing number of publications concerning the roles and impacts of pharmacists. Decision makers, clinicians and patients need evidence to support an appropriate allocation of funds to better use the expertise of pharmacists.
Purpose
To provide a profile of the roles and impacts of the pharmacist in the literature.
Material and methods
Review of literature. Articles in English and French related to the roles and the impacts of the pharmacist were selected, according a reproducible search strategy from 1990 to September 2017 in Pubmed and Pubmed Central. The following variables were extracted: author, country, study plan, pharmaceutical activities, patient care programmes, diseases, outcomes (e.g. mortality, morbidity, costs, adverse events, medication errors, compliance, satisfaction, other) and a quality score. Outcome results were categorised as positive, neutral or negative. Only descriptive statistics were performed.
Results
On 20 September, 2017, a total of 2323 articles were included on 100 themes (e.g. 41 pharmaceutical activities, 30 diseases and 29 patient care programmes). Studies were conducted in the United States (46.6%), multiple countries (8.2%), Canada (7.8%), France (6.2%), the United Kingdom (5.3%), Australia (3.6%) and other countries (19.3%). Studies were either cross-sectional (47%), retrospective (33%), prospective (18%) or uncategorised (12%). Outcomes included morbidity (22%), medication errors (11.7%), satisfaction (7.3%), adherence (6%), costs (5.6%), adverse reactions (3.7%), mortality (1.3%) and others (42.4%). Included studies reported 6784 descriptive indicators and 5108 outcome indicators (60% were positive, 39% neutral and 1% negative). The quality score of articles (n=1,697) were either excellent (8.8%), acceptable (34.2%) or with methodological limitations (57%).
Conclusion
This review of the literature confirms the extensive presence of pharmacists in numerous patient care programmes, treating different diseases and performing a variety of pharmaceutical activities. Most outcomes related to pharmaceutical activities were positive. However, a significant proportion of published studies had methodological limitations. Pharmacists need to be more exposed to evidence about their roles and their impact, both in community and hospital settings. Furthermore, increasing funding for evaluative research must be supported by external stakeholders in different countries to better understand the impact of pharmacists' activities. No conflict of interest