The impact of pharmacist interventions on health-related quality of life
Pickard A S, Johnson J A, Farris K B
Authors' objectives
To describe and evaluate pharmacy-based studies that include health-related quality of life (HRQL) as an outcome
measure and to recommend approaches for incorporating HRQL as a patient outcome in pharmacy-based intervention
studies.
Searching
Computerised searches were conducted of the following databases from January 1988 to February 1999: MEDLINE,
Healthstar, EMBASE and International Pharmaceutical Abstracts. MeSH terms and non-MeSH keywords used to
describe HRQL and pharmacist interventions were used. Reference lists for reviewed papers were cross-checked for
additional relevant citations. Efforts were made to identify complete articles published subsequent to abstracts reporting
research in progress.
Study selection
Study designs of evaluations included in the review
Included studies were of the following designs: randomised controlled trials (RCTs); concurrent cohort studies; pre and
post prospective studies with no control group; and pre and post studies with nonequivalent control. Duration of studies
ranged from 1.5 months to 24 months. Abstracts presenting partial findings or work in progress were not included in the
review unless actual HRQL outcome data was reported. There appeared to be no restrictions applied to study design.
Specific interventions included in the review
The inclusion criteria were any pharmacist based intervention. The following pharmacist-based interventions were
included: clinical pharmacist interventions; pharmaceutical care; comprehensive pharmaceutical services; community
pharmacist with or without training programme; and pharmacist consultation. Interventions included disease specific
interventions.
Participants included in the review
Participants included the general public and patients with the following medical problems: elderly outpatients; diabetes;
hypertension; asthma; hyperlipidaemia; and chronic obstructive pulmonary disease. Inclusion criteria for participants
were not stated.
Outcomes assessed in the review
Inclusion criteria was patients health-related quality of life (HRQL) which was evaluated was evaluated using the
generic 36-Item Short-Form Health Survey (SF-36) or its variations (see Other Publications of Related Interest no.1);
Health Status Questionnaire; SF-12; visual analogue scale; or disease specific instruments (including
Hypertension/Lipid Form 5.1, disease specific hypertension questionnaire, asthma-related quality of life, and Diabetes
Form 2.1) either alone or complemented by a generic measure.
How were decisions on the relevance of primary studies made?
Abstracts of unique citations were reviewed by two researchers. Abstracts potentially meeting the inclusion criteria
were identified and the complete articles retrieved for fuller scrutiny.
Assessment of study quality
Some aspects of validity were discussed in the text though no systematic assessment of validity was undertaken. The
authors do not state how the papers were assessed for validity, or how many of the reviewers performed the validity
assessment.
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