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      Patient and public perspectives of community pharmacies in the United Kingdom: A systematic review

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          Abstract

          Background

          The United Kingdom has been at the forefront of enhancing pharmacist roles and community pharmacy services, particularly over the past decade. However, patient and public awareness of community pharmacy services has been limited.

          Objective

          To identify and synthesize the research literature pertaining to patient and public perspectives on: existing community pharmacy services, extended pharmacist roles and strategies to raise awareness of community pharmacy services.

          Search strategy

          Systematic search of 8 electronic databases; hand searching of relevant journals, reference lists and conference proceedings.

          Inclusion criteria

          UK studies investigating patient or public views on community pharmacy services or pharmacist roles from 2005 to 2016.

          Data extraction and synthesis

          Data were extracted into a grid and subjected to narrative synthesis following thematic analysis.

          Main results

          From the 3260 unique papers identified, 30 studies were included. Manual searching identified 4 additional studies. Designs using questionnaires (n = 14, 41%), semi‐structured interviews (n = 8, 24%) and focus groups (n = 6, 18%) made up the greatest proportion of studies. Most of the studies (n = 28, 82%) were published from 2010 onwards and covered perceptions of specific community pharmacy services (n = 31). Using a critical appraisal checklist, the overall quality of studies was deemed acceptable. Findings were grouped into 2 main themes “public cognizance” and “attitudes towards services” each with 4 subthemes.

          Discussion and conclusions

          Patients and the public appeared to view services as beneficial. Successful integration of extended pharmacy services requires pharmacists’ clinical skills to be recognized by patients and physicians. Future research should explore different approaches to increase awareness.

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          Most cited references76

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          Physician and pharmacist collaboration to improve blood pressure control.

          Studies have demonstrated that blood pressure (BP) control can be improved when clinical pharmacists assist with patient management. The objective of this study was to evaluate if a physician and pharmacist collaborative model in community-based medical offices could improve BP control. This was a prospective, cluster randomized, controlled clinical trial with clinics randomized to a control group (n = 3) or to an intervention group (n = 3). The study enrolled 402 patients (mean age, 58.3 years) with uncontrolled hypertension. Clinical pharmacists made drug therapy recommendations to physicians based on national guidelines. Research nurses performed BP measurements and 24-hour BP monitoring. The mean (SD) guideline adherence scores increased from 49.4 (19.3) at baseline to 53.4 (18.1) at 6 months (8.1% increase) in the control group and from 40.4 (22.6) at baseline to 62.8 (13.5) at 6 months (55.4% increase) in the intervention group (P = .09 for adjusted between-group comparison). The mean BP decreased 6.8/4.5 mm Hg in the control group and 20.7/9.7 mm Hg in the intervention group (P < .05 for between-group systolic BP comparison). The adjusted difference in systolic BP was -12.0 (95% confidence interval [CI], -24.0 to 0.0) mm Hg, while the adjusted difference in diastolic BP was -1.8 (95% CI, -11.9 to 8.3) mm Hg. The 24-hour BP levels showed similar effect sizes. Blood pressure was controlled in 29.9% of patients in the control group and in 63.9% of patients in the intervention group (adjusted odds ratio, 3.2; 95% CI, 2.0-5.1; P < .001). A physician and pharmacist collaborative intervention achieved significantly better mean BP and overall BP control rates compared with a control group. Additional research should be conducted to evaluate efficient strategies to implement team-based chronic disease management. clinicaltrials.gov Identifier: NCT00201019.
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            Paying pharmacists for patient care: A systematic review of remunerated pharmacy clinical care services.

            Expansion of scope of practice and diminishing revenues from dispensing are requiring pharmacists to increasingly adopt clinical care services into their practices. Pharmacists must be able to receive payment in order for provision of clinical care to be sustainable. The objective of this study is to update a previous systematic review by identifying remunerated pharmacist clinical care programs worldwide and reporting on uptake and patient care outcomes observed as a result.
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              • Article: not found

              The impact of interventions by pharmacists in community pharmacies on control of hypertension: a systematic review and meta-analysis of randomized controlled trials.

              To undertake a systematic review and meta-analysis of randomized controlled trials concerned with the impact of community pharmacist-led interventions on blood pressure control in patients with hypertension.
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                Author and article information

                Contributors
                ali.hindi@postgrad.manchester.ac.uk
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                08 November 2017
                April 2018
                : 21
                : 2 ( doiID: 10.1111/hex.2018.21.issue-2 )
                : 409-428
                Affiliations
                [ 1 ] Centre for Pharmacy Workforce Studies Division of Pharmacy and Optometry School of Health Sciences Faculty of Biology, Medicine and Health The University of Manchester Manchester UK
                Author notes
                [*] [* ] Correspondence

                Ali M. K. Hindi, Centre for Pharmacy Workforce Studies, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.

                Email: ali.hindi@ 123456postgrad.manchester.ac.uk

                Author information
                http://orcid.org/0000-0002-1076-435X
                http://orcid.org/0000-0002-6199-5748
                Article
                HEX12639
                10.1111/hex.12639
                5867331
                29114971
                c7543748-3118-4d41-9b39-3d0565af0523
                © 2017 The Authors. Health Expectations published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 September 2017
                Page count
                Figures: 2, Tables: 3, Pages: 20, Words: 12850
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                hex12639
                April 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.3.3 mode:remove_FC converted:26.03.2018

                Health & Social care
                community pharmacy,health services,patient and public users,public health services,systematic review

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