Implementation of Clinical Pharmacy Services in Primary Health Care: A Scoping Review

Abstract

Rationale

The implementation of Clinical Pharmacy Services in healthcare systems is multifactorial and complex. Some studies summarize the implementation research of these services in both outpatient and inpatient contexts. However, the literature lacks a comprehensive synthesis to understand how the implementation process occurs in Primary Health Care.

Aim

To map, at an international level, the studies on the implementation of Clinical Pharmacy Services in Primary Health Care.

Method

This scoping review followed the recommendations of the JBI Manual for Evidence Synthesis for Scoping Reviews. A systematic search was conducted in May 2023 across six electronic databases, grey literature, and the references of the selected studies. Original studies that described the implementation process of Clinical Pharmacy Services in Primary Health Care were eligible for inclusion. Two researchers independently assessed the studies based on eligibility criteria and extracted data from the selected articles. Data were presented descriptively.

Results

A total of 97 studies were included, with 85.6% (n = 83) conducted in developed countries. A significant emphasis was observed on qualitative and mixed-methods research, accounting for 46.4% (n = 45) of the studies. Only 22.7% (n = 22) of the studies utilized theoretical models as research guides, while 96.9% (n = 94), did not report on the implementation phase. Comprehensive Medication Management (36.8%, n = 35) was the most cited type of service. The most assessed implementation outcome was feasibility, at 73.2% (n = 71). A total of 47.4% (n = 46) assessed outcomes related to the implemented service, which included clinical, economic, and/or humanistic aspects.

Conclusion

This study revealed numerous publications on the implementation of clinical services provided by pharmacists in primary care. These findings can guide future research on the implementation of these services and highlight the need for developing and underdeveloped countries to explore this topic further.