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Tools for Assessing Potential Significance of Pharmacist Interventions: A Systematic Review

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Abstract

Introduction

Assessing the significance of pharmacist interventions (PIs) is essential to demonstrate the added value of pharmacists. Methods and tools for assessing the potential significance of PIs are diverse and their properties are questionable.

Objectives

We aimed to systematically review the tools available to assess the potential significance of PIs.

Methods

We conducted a systematic search for English- or French-language publications from 1986 to 2013 in PubMed, PsycINFO, PASCAL, and CINAHL. Studies were screened by two independent reviewers based on inclusion/exclusion criteria and were abstracted for content, structure of tools, and validation process.

Results

Of 873 citations screened, 82 distinct tools were identified from 133 studies. While clinical aspects were often defined quite clearly, terminology regarding humanistic, economic, and process-related aspects of PIs was omitted, incomplete, or ambiguous in most tools. The probabilities of consequences of PIs/drug-related problems were evaluated in 20/82 tools. Few tools simultaneously measured economic, clinical, humanistic, and process-related variables. Structure of the tools varied from an implicit, mono-dimensional tool to an explicit, multi-dimensional algorithm. Validation processes were diverse in terms of quantification and number of raters, rating method, and psychometric parameters. Of 133 identified studies, there was limited evidence of validity (8/133, 6.0 %), inter-rater reliability (49/133, 36.8 %), and intra-rater reliability (2/133, 1.5 %).

Conclusions

The majority of tools focused primarily on assessing clinical aspects and failed to detect comprehensive impacts. The heterogeneity of tools and assessment processes hindered our ability to synthesize the results of evaluations. Limited results for their validity and reliability cast doubt on the credibility of this methodology for justification of the value of PIs. Recommendations for development of tools with optimal theoretical, pragmatic, and psychometric properties are proposed.

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Acknowledgments

The authors wish to thank Dr. Alison Foote (Grenoble Clinical Research Centre) for critically reading and editing the manuscript; the librarians of the Grenoble Faculty of Medicine and Pharmacy; and Monique Boucquin from CDIP, Hospices Civils de Lyon for the literature search.

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Authors and Affiliations

  1. Univ. Grenoble Alpes, Grenoble, France

    Thi-Ha Vo, Bruno Charpiat, Claire Catoire, Sébastien Chanoine, Jean-Luc Bosson, Benoît Allenet & Pierrick Bedouch

  2. CNRS, TIMC-IMAG, Grenoble, France

    Thi-Ha Vo, Bruno Charpiat, Claire Catoire, Jean-Luc Bosson, Benoît Allenet & Pierrick Bedouch

  3. Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Pharmacie, Lyon, France

    Bruno Charpiat

  4. Pôle Pharmacie, Pavillon Vercors, CHU Grenoble, CS 10217, 38043, Grenoble cedex 9, France

    Claire Catoire, Sébastien Chanoine, Benoît Allenet & Pierrick Bedouch

  5. Centre Hospitalier Auban-Moët, Pharmacie, Epernay, France

    Michel Juste

  6. Centre Hospitalier Lucien Hussel, Pharmacie, Vienne, France

    Renaud Roubille

  7. EPSM-Morbihan, Pharmacie, Saint-Avé, France

    François-Xavier Rose

  8. Assistance Publique des Hôpitaux de Paris, Hôpital Cochin, Pharmacie, Paris, France

    Ornella Conort

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On Behalf of the Working Group “Standardizing and Demonstrating the Value of Clinical Pharmacy Activities” of the French Society for Clinical Pharmacy

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Correspondence to Pierrick Bedouch.

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Thi-Ha Vo, Bruno Charpiat, Claire Catoire, Michel Juste, Renaud Roubille, François-Xavier Rose, Sébastien Chanoine, Jean-Luc Bosson, Ornella Conort, Benoît Allenet, and Pierrick Bedouch declare that they have no conflicts of interest.

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Vo, TH., Charpiat, B., Catoire, C. et al. Tools for Assessing Potential Significance of Pharmacist Interventions: A Systematic Review. Drug Saf 39, 131–146 (2016). https://doi.org/10.1007/s40264-015-0370-0

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