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Agreement between process measures and outcomes of Clinical Pharmacy Services in Brazilians with cardiometabolic diseases

  • At: PPR SIG 2021 (2021)
  • Type: Digital
  • By: FORGERINI, Marcela (São Paulo State University (UNESP), Brazil)
  • Co-author(s): 1. Marcela Forgerini. PhD. Postdoctoral student. Department of Drugs and Medicines, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil.(marcelaforgerini@gmail.com) 2. Priscila Leone Nassur. Master student. Department of Drugs and Medicines, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil.(priscilalnassur@gmail.com) 3. Patrícia de Carvalho Mastroianni. PhD. Associate Professor. Department of Drugs and Medicines, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil. (patricia.mastroianni@unesp.br)
  • Abstract:

    Introduction

    Effectiveness of clinical pharmacy services (CPS) is assessed through indicators, such as measures of processes (e.g., drug related problem (DRPs)) and outcomes that are performed using clinical, humanistic and economic parameters. Nevertheless, little is known about the agreement between process measures and outcomes of CPS in Brazilians with cardiometabolic diseases.

    Objectives

    To assess the agreement between process measures and outcomes of CPS conducted with Brazilians with cardiometabolic diseases.

    Methods

    Systematic review conducted in Scopus, Lilacs and PubMed. Studies that conducted CPS and reported process measures and clinical, humanistic and/or economic outcomes were included. Bias risk was assessed using Cochrane Collaboration tools.

    Results

    Among 2,486 studies screened, 22 studies and 1,198 participants (762 women) were included. The most reported process measures were DRPs (n=14), adherence (n=11) and number of medications in use (n=8). These measures were identified more often than relevant clinical outcomes in patient care with cardiometabolic disease (i.e., blood pressure). Eleven studies reported the number of identified DRP, with 84.9% being resolved (1,005/854); and eight studies showed an improvement in adherence (8/11). Agreement between the DRP and adherence measures and changes in blood pressure values, incremental cost-effectiveness ratios and quality of life was identified. Weak agreement was identified between the number of medications in use and the outcomes evaluated. The studies showed a high risk of bias and potential publication bias.

    Conclusion

    The process measures DRPs and adherence showed a good agreement with the outcomes assessed during CPS in Brazilians with cardiometabolic diseases. However, these findings should be considered with caution as the high risk of bias and the potential publication bias may have contributed to the identification of a good agreement. Well-designed studies are needed in order to identify the appropriate process measures to optimize the assessment of outcomes of CPS. Funding PIBIC (51798); CNPq (459461/2014-1); FAPESP (2018/07501-9); CAPES (Finance Code 001).

Last update 4 October 2019

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