Critical analysis of the pharmaceutical care research literature

OBJECTIVE: TO describe and evaluate published pharmaceutical care research and make recommendations to improve the quality of the literature. DATA SOURCES: MEDLINE and International Pharmaceutical Abstracts using the key word "pharmaceutical care," limited to research articles published January 1988-December 1996. STUDY SELECTION: Articles that evaluated the provision of pharmaceutical care in a defined population. DATA EXTRACTION: Citations (title and abstract) identified were reviewed. Articles potentially meeting the inclusion criteria were screened and scored according to the Pharmaceutical Care Research Checklist for the presence of criteria including pharmaceutical care process, methodology, and measures/outcomes. RESULTS: A total of 979 citations were identified. Of 57 abstracts identified as potentially meeting the inclusion criteria, 43 articles were eliminated, 2 were rejected, and 12 were accepted for analysis. Deficiencies identified included: a lack of research in community practice (n = 2), randomized controlled trials (n = 3), workload measurement (n = 6), and patient satisfaction (n = 1). Scoring according to the Pharmaceutical Care Research Checklist also identified the following deficiencies (maximum Composite Criterion Score [CCS] of 24): description of population sample (CCS 17), dropouts (CCS 13), informed consent (CCS 8), pharmacist training/qualifications (CCS 9), instrument validity (CCS 10), structure criteria (CCS 4), patient outcomes (CCS 11), and economic outcomes (CCS 12). The mean total checklist score was 37 of 50 (range 31-46). CONCLUSIONS: Few research studies have evaluated the provision of pharmaceutical care in a defined population. Deficiencies identified by low CCSs demonstrate the need for quality research design and a clear description of the pharmaceutical care process to evaluate the impact of pharmaceutical care. Recommendations for improvement in research design were made.