Many studies have demonstrated the beneficial effects that pharmacist-provided patient care services can have on patient health outcomes. However, the effectiveness of patient care services delivered by pharmacists in community pharmacy settings, where organizational barriers may affect service implementation or limit effectiveness, remains unclear. The authors systematically reviewed the literature on the effectiveness of pharmacist-delivered patient care services in community pharmacy settings in the United States. Of the 749 articles retrieved, 21 were eligible for inclusion in the review. Information concerning 134 outcomes was extracted from the included articles. Of these, 50 (37.3%) demonstrated statistically significant, beneficial intervention effects. The percentage of studies reporting favorable findings ranged from 50% for blood pressure to 0% for lipids, safety outcomes, and quality of life. Our findings suggest that evidence supporting the effectiveness of pharmacist-provided direct patient care services delivered in the community pharmacy setting is more limited than in other settings.
Purpose. To evaluate the effects of two interventions on calcium intake and exercise and assess whether intervention effects varied as a function of participants' stage of change. Design. The study used a 2 by 2 factorial research design. Baseline, 3-, 6-, and 12-month follow-up data were collected. Setting. Twelve counties in western North Carolina. Subjects. Of 714 women recruited, 547 (76.6%) completed all data collection procedures. Intervention. One intervention, conducted at the individual level, compared the effects of tailored vs. nontailored educational materials. The tailored educational intervention was delivered via two packets of written materials and one telephone counseling session. The written materials and counseling session were tailored according to participants' current calcium intake and exercise level, perceived adequacy of these behaviors, stage of change, behavioral goals, and perceived barriers to change. A community-based intervention was also evaluated. This intervention, implemented in 6 of the 12 counties, included establishing an Osteoporosis Resource Center, conducting a workshop on osteoporosis prevention, and offering free bone density screening. Measures. Outcome measures were calcium intake and exercise level. Stage of change was assessed as a moderating variable. Results. Irrespective of intervention group, among women not consuming adequate calcium at baseline, intake increased an average of about 500 mg/d over the course of the study. Changes involving exercise were more modest. Repeated measures regression analyses were used to evaluate intervention effects. The effect of the tailored educational intervention varied, in appropriate ways, among women in different stages of change at baseline ( F2, 527 = 6.37, p < .002). Among women in the Engaged stage, the tailored intervention was associated with a greater increase in calcium intake. In contrast, among women who were obtaining adequate calcium at baseline (i.e., Action stage), the tailored intervention appeared to forestall inappropriate increases in calcium intake. The community-based intervention had no consistent effects on calcium intake, either alone, or in combination with the tailored intervention. Finally, neither intervention had an effect on exercise, either alone or in combination. Conclusions. Limited support for the superiority of tailored vs. nontailored educational interventions was found. The differential effects observed could be due to the telephone counseling received by women in the Tailored Education Group, however.
Purpose. This study examined the effects of brief written educational materials on osteoporosis-related knowledge, beliefs, and behaviors. The study also examined whether observed effects varied as a function of one's stage in the precaution adoption process. Design. The study used an experimental research design. Setting. Participants were identified from North Carolina driver's license records. Subjects. Of the 1476 women in the initial sample, 536 (36.3%) enrolled in the study and 307 completed all follow-up assessments. Intervention. Participants were randomly assigned to one of four groups. One group received an information packet containing general information about osteoporosis. One group received an action plan packet containing instructions on how to increase one's level of exercise and calcium intake. One group received both packets. The final group received neither packet. Measures. Primary study variables were beliefs related to osteoporosis, calcium, and exercise; osteoporosis knowledge; calcium and exercise stage; calcium intake; and exercise level. Results. Overall, receipt of the information packet was associated with changes in knowledge and beliefs (F[18,283] = 2.11, p < .01) irrespective of participants' stage of change. No effects on behavior were observed. Conclusions. These findings suggest that brief written educational materials can facilitate knowledge and belief change but that they do not promote behavior change. The generalizability of these findings is limited by the low study response rate.
