Mapping community pharmacy services in Brazil: a scoping review

Abstract The delivery of clinical pharmacy services has been growing in Brazilian community pharmacies, and it is necessary to have a comprehensive understanding of the topic. This scoping review aimed to provide an overview of Brazilian studies about clinical pharmacy services in community pharmacies. Original research articles, with no restriction of time, study design, or patient’s health condition, were included. Searches were conducted in PubMed, Scopus, Web of Science, Scielo, and Lilacs. Two reviewers conducted the screening, full-text reading, and data extraction independently. ROB and ROBINS-I were used for the assessment of quality. Charts and tables were built to summarise the data. Seventy-two articles were included. A diversity of study designs, number of participants, terms used, and outcomes was found. São Paulo and Sergipe States had the highest number of studies (n=10). Pharmacists’ interventions were not fully reported in 65% of studies, and most studies presented an unclear risk of bias. Studies were very diverse, impairing the comparisons between the results and hindering their reproducibility. This review suggests using guidelines and checklists for better structuration of pharmacists’ interventions as well as reporting results and measuring fidelity in future research.

摘要 巴西社区药房的临床药学服务供给规模持续扩张，亟需对该主题开展全面系统的认知。本范围综述旨在全面梳理巴西针对社区药房临床药学服务的相关研究。研究纳入未限制发表时间、研究设计类型及患者健康状况的原创性研究论文，检索数据库涵盖PubMed、Scopus、Web of Science、Scielo及Lilacs。由两名评价者独立完成文献筛选、全文阅读与数据提取工作，采用偏倚风险（Risk of Bias, ROB）工具与非随机研究偏倚风险（Risk Of Bias In Non-randomized Studies - of Interventions, ROBINS-I）工具开展质量评价，并通过图表汇总提取的数据。最终共纳入72篇文献，纳入研究的设计类型、受试者人数、所用术语及结局指标均存在显著异质性；圣保罗州与塞尔希培州的相关研究数量最多（n=10）。65%的研究未完整报告药师干预措施，且多数研究的偏倚风险评级为不明确。纳入研究的异质性极强，既阻碍了研究结果间的横向比较，也限制了研究成果的可重复性。本综述建议，未来相关研究应采用指南与核查清单规范药师干预措施的设计，同时完善结果报告与干预保真度的测量流程。