CRITICAL ANALYSIS OF THE PHARMACEUTICAL CARE RESEARCH LITERATURE

OBJECTIVE: TO describe and evaluate published pharmaceutical care rese arch and make recommendations to improve the quality of the literature . DATA SOURCES: MEDLINE and International Pharmaceutical Abstracts usi ng the key word ''pharmaceutical care,'' limited to research articles published January 1988-December 1996. STUDY SELECTION: Articles that e valuated the provision of pharmaceutical care in a defined population. DATA EXTRACTION: Citations (title and abstract) identified were revie wed. Articles potentially meeting the inclusion criteria were screened and scored according to the Pharmaceutical Care Research Checklist fo r the presence of criteria including pharmaceutical care process, meth odology, and measures/outcomes. RESULTS: A total of 979 citations were identified. Of 57 abstracts identified as potentially meeting the inc lusion criteria, 43 articles were eliminated, 2 were rejected, and 12 were accepted for analysis. Deficiencies identified included: a lack o f 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 al so identified the following deficiencies (maximum Composite Criterion Score [CCS] of 24): description of population sample (CCS 17), dropout s (CCS 13), informed consent (CCS 8), pharmacist training/qualificatio ns (CCS 9), instrument validity (CCS 10), structure criteria (CCS 4), patient outcomes (CCS 11), and economic outcomes (CCS 12). The mean to tal checklist score was 37 of 50 (range 31-46). CONCLUSIONS: Few resea rch studies have evaluated the provision of pharmaceutical care in a d efined population. Deficiencies identified by low CCSs demonstrate the need for quality research design and a clear description of the pharm aceutical care process to evaluate the impact of pharmaceutical care. Recommendations for improvement in research design were made.