Protocol for systematic review and meta-analysis of randomized controlled trials, cost-benefit analysis and interrupted timeseries interventions on pharmacist’s prescribing

Main Article Content


Collaborative , Prescribing, Cost-benefit analysis , Dependent prescribing, Cmergency pharmacist-prescribing, Independent prescribing, Interrupted time-series interventions, Randomized controlled trials


Background: Shortening the process of prescribing via permitting the pharmacist to select the most appropriate pharmaceuticals for each particular patient may provide great opportunities for pharmacists to develop suitable pharmaceutical care plan, monitor and follow up prescribed medications, communicate and consult physicians for more confirmations. Objective: The objective of the current protocol for the systematic review and meta-analysis of pharmacists prescribing interventions was to explore, investigate the evidence, assess and compare PICO in patients with medical conditions (population), receiving pharmacist’s prescribing care services (interventions) versus non-pharmacist’s prescribing (comparators), and identify how it will impact the clinical, humanistic, and economic patient’s outcomes (outcomes). Methods: The necessary elements of PRISMA will be strictly followed to report the systematic review. The meta-analysis will be reported in line with the Cochrane guidelines for synthesis of trials and all forms will be based on quality measures as per the validated Cochrane templates. We will present the results of the systematic review and the meta-analysis based on PICO comparison between the included trials. Results: We have identified four models of pharmacist prescribing interventions (independent, dependent [collaborative], supplementary, and emergency prescribing). The results will contain a systematic critical evaluation of the included trials in terms of the sample number of the population (characteristics), the type of interventions and the comparators, and the main outcome measures. Conclusion: This protocol will report the evidence and explore the magnitude of impact of pharmacist prescribing interventions, on clinical, humanistic, and economic outcomes. .

Abstract 1092 | PDF Downloads 376


1. Korb-Savoldelli V, Boussadi A, Durieux P, et al. Prevalence of computerized physician order entry systems-related medication prescription errors: A systematic review. Int J Med Inform. 2018;111:112-122.
2. Tsuyuki RT, Watson KE. Why pharmacist prescribing needs to be independent. Can Pharm J. 2020;153(2):67-69.
3. Pearson G, Yuksel N, Card D, et al. An information paper on pharmacist prescribing within a health care facility. The Canadian
Journal of Hospital Pharmacy (CJHP). 2002;55(1).
4. Zhou M, Desborough J, Parkinson A, et al. Barriers to pharmacist prescribing: a scoping review comparing the UK, New Zealand, Canadian and Australian experiences. IJPP. 2019;27(6):479-489.
5. Spann N, Hamper J, Griffith R, et al. Independent pharmacist prescribing of statins for patients with type 2 diabetes: an analysis of enhanced pharmacist prescriptive authority in Idaho. Journal of the American Pharmacists Association. 2020;60(3):S108- 114.
6. Jebara T, Cunningham S, MacLure K, et al. Stakeholders’ views and experiences of pharmacist prescribing: a systematic review.British Journal of Clinical Pharmacology. 2018;84(9):1883-1905.
7. Greenwood D, Tully MP, Martin S, et al. The description and definition of Emergency Department Pharmacist Practitioners in the United Kingdom (the ENDPAPER study). International Journal of Clinical Pharmacy. 2019;41(2):434-444.
8. Pérez-Moreno MA, Rodríguez-Camacho JM, Calderón-Hernanz B, et al. Clinical relevance of pharmacist intervention in anemergency department. Emergency Medicine Journal. 2017;34(8):495-501.
9. Ortmann MJ, Johnson EG, Jarrell DH, et al. ASHP guidelines on emergency medicine pharmacist services. American Journal of Health-System Pharmacy. 2021;78(3):261-275.
10. Al Hamarneh YN, Rosenthal M, McElnay JC, et al. Pharmacists’ perceptions of their professional role: insights into hospital pharmacy culture. The Canadian Journal of Hospital Pharmacy. 2011;64(1):31.
11. 11a. Retrieved January 23, 2022 or the high quality standards of Cochrane collaboration, “Cochrane Handbook for Systematic Reviews of Interventions”. Retrieved January 25, 2022. 11b. “The PRISMA
Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration”. PLoS Medicine 6(7):e1000100.
12. What Works Clearinghouse Procedures and Standards Handbook. 2010:37-46.
13. Borenstein, Hedges Higgins, and Rothstein. Introduction to meta-analysis. John Wiley and Sons Ltd. 2. 2009;21-32.
14. Carole Torgerson and David Torgerson (2013) Randomised trials in education: An introductory handbook. EEF:
15. Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions. Version 5.1.0 (updated March 2011).
The Cochrane Collaboration, 2011.
16. Hedges L, Olkin I. Statistical Methods for Meta-analysis. San Diego, CA: Academic Press. 1985.
17. Stewart D, Pallivalapila A, Thomas B, et al. A theoretically informed, mixed-methods study of pharmacists’ aspirations and readiness to implement pharmacist prescribing. Int J Clin Pharm. 2021;43(6):1638-1650.
18. Ajabnoor AM, Cooper RJ. Pharmacists’ Prescribing in Saudi Arabia: Cross-Sectional Study Describing Current Practices and Future Perspectives. Pharmacy. 2020;8(3):160.
19. Poh EW, McArthur A, Stephenson M, et al. Effects of pharmacist prescribing on patient outcomes in the hospital setting: a systematic review. JBI Evidence Synthesis. 2018;16(9):1823-1873.
20. Tsuyuki RT, Al Hamarneh YN, Jones CA, et al. The Effectiveness of Pharmacist Interventions on Cardiovascular Risk: The Multicenter Randomized Controlled RxEACH Trial. J Am Coll Cardiol. 2016;67(24):2846-2854. jacc.2016.03.528
21. Tsuyuki RT, Rosenthal M, Pearson GJ. A randomized trial of a community-based approach to dyslipidemia management:Pharmacist prescribing to achieve cholesterol targets (RxACT Study). Can Pharm J (Ott). 2016;149(5):283-292.
22. Yuksel N, Eberhart G, Bungard TJ. Prescribing by pharmacists in Alberta. American Journal of Health-System Pharmacy.2008;65(22):2126-2132.
23. Chisholm-Burns MA, Lee JK, Spivey CA, et al. US pharmacists’ effect as team members on patient care: systematic review and meta-analyses. Medical care. 2010;48(10):923-933.
24. Chisholm-Burns MA, Graff Zivin JS, Lee JK, et al. Economic effects of pharmacists on health outcomes in the United States: a systematic review. American Journal of Health-System Pharmacy. 2010;67(19):1624-1634.
25. Kelly DV, Bishop L, Young S, et al. Pharmacist and physician views on collaborative practice: Findings from the community pharmaceutical care project: Findings from the community pharmaceutical care project. Can Pharm J (Ott). 2013;146(4):218-226.
26. Zimmermann A, Płaczek J, Wrzosek N, et al. Assessment of Pharmacists Prescribing Practices in Poland—A Descriptive Study. InHealthcare. Multidisciplinary Digital Publishing Institute. 2021;9(11):1505.
27. Stewart D, MacLure K, George J. Educating non-medical prescribers. Brit J Clin Pharmacol. 2012;74:662-667.
28. Cope CP, Abuzour AS, Tully MP. Nonmedical prescribing: where are we now? Ther Adv Drug Saf. 2016;7(4):165-712.
29. Stewart D, Jebara T, Cunningham S, et al. Future perspectives on nonmedical prescribing. Ther Adv Drug Saf. 2017;8(6):183-197.

Most read articles by the same author(s)