An analysis of quality of systematic reviews on pharmacist health interventions

Background In the past 20 years, many studies have evaluated the impact of pharmaceutical practices on clinical, humanistic and economic outcomes. However, few studies have critically analysed the primary studies and published reviews regarding pharmaceutical practices. Aim of the Review The aim of this review is to assess the quality of systematic reviews and meta-analysis on pharmacist health interventions published from 1990 to 2009. Method The data sources used were MEDLINE, Cochrane Library, International Pharmaceutical Abstracts, Latin American and Caribbean Health Sciences, Scientific Electronic Library Online, and Scopus. Studies in which interventions were done by a pharmacist or in which the pharmacist was a health team member were included. There were no restrictions based on the type of intervention, country or languages. The data extracted by two independent reviewers were the following: publication journal, language, publication year, search strategy, study design, quality assessment of the included studies, disease, study settings, intervention description, and outcome measures. The methodological quality of systematic reviews was accessed with AMSTAR. Results A total of 151 articles were found from which 31 were included. An increase in the number of publications occurred after 2005. Nineteen reviews evaluated the quality of primary studies, and 6 of these reviews performed meta-analyses. The methodological quality of reviews was considered to be moderate (52.8 ± 22.3% for reviewer #1 and 54.8 ± 16.5% for reviewer #2); of the 31 included reviews, 7, 18 and 6 reviews had high, moderate and poor quality, respectively. Conclusion The quality of published reviews varies from moderate to poor. Improvements in the study design can be achieved by following specific recommendations, such as clearly describing the methods, performing the data extraction in duplicate, researching at least two databases, listing the included and excluded studies, employing tables with the main studies data and evaluating and reporting the scientific quality of the included articles