Does drug dispensing improve the health outcomes of patients attending community pharmacies? A systematic review

BACKGROUND

Drug dispensing is a clinical pharmacy service that promotes access to medicines and their rational use. However, there is a lack of evidence for the impact of drug dispensing on patients' health outcomes. Thus, the purpose of this study was to assess the influence of drug dispensing on the clinical, humanistic, and economic outcomes of patients attending community pharmacies.

METHODS

A systematic literature search was performed in April 2021 using PubMed, Web of Science, Cochrane Library, LILACS, and Open Thesis. Two reviewers screened titles, abstracts, and full-text articles according to the eligibility criteria. Methodological quality was assessed using tools from the Joanna Briggs Institute, and the literature was synthesized narratively.

RESULTS

We retrieved 3,685 articles and included nine studies that presented 13 different outcomes. Regarding the design, they were cross-sectional (n = 4), randomized clinical trials (n = 4), and quasi-experimental (n = 1). A positive influence of drug dispensing on health outcomes was demonstrated through six clinical, four humanistic and three economic outcomes. Eight studies (88,9 %) used intermediate outcomes. The assessment of methodological quality was characterized by a lack of clarity and/or lack of information in primary studies.

CONCLUSIONS

Most articles included in this review reported a positive influence of drug dispensing performed by community pharmacists on patients' health outcomes. The findings of this study may be of interest to patients, pharmacists, decision makers, and healthcare systems, since they may contribute to evidence-based decision-making, strengthening the contribution of community pharmacists to health care.

TRIAL REGISTRATION

Registration: PROSPERO CRD42020191701 .

Identification of seven isolants of infectious bronchitis virus by interference with the B-1 isolant of Newcastle disease virus

Seven isolants of infectious bronchitis virus (IBV) interfered with the development of hemagglutinins (HA) by the B-1 isolant of Newcaslte disease virus (NDV) in eggs previously inoculated with these IBV isolants. The I50 [defined as the minimum amount of IBV needed to produce, upon inoculation in embryonating chicken eggs (ECE), HA interference in 50% of these ECE reioculated 10 hr later with 10(2,41 EID50 (HA) of the B-1 strain of NDV] was less than 1 EID50. The interference was considered specific for IBV because if could be eliminated by addition of homologous anti-IBV serum. Furthermore, three other common poultry viruses (laryngotracheitis, fowlpox, and CELO viruses) did not interfere with NDV. In view of its sensitivity, specificity, and simplicity of performance, the IBV-NDV interference test appears to have considerable potential as a diagnostic test for IBV under field conditions.

Two new isolants of infectious bronchitis virus with polyvalent immunogenicity

The immunizing capacity of two new field isolants of avian infectious bronchitis virus (IBV) was tested in vivo. Chickens vaccinated with either isolant resisted challenge with 6 serotypes of IBV, including some of the types most commonly isolated from chickens. The two new isolants, identified herein as California "G" and California "S," appear to be immunologically different from each other and from the other 6 types tested. The polyvalent immunogenicity of both G and S is noteworthy, and potentially a very promising characteristic for the development of effective vaccines. The immunogenicity is slightly better for G than for S, but both are still pathogenic for chickens. Therefore, they should be attenuated before being used as vaccines.

Identification of infectious bronchitis virus by interference with the B-1 isolant of Newcastle disease virus. Waxing and waning of interference

The Massachusetts and the Connecticut types of infectious bronchitis virus (IBV) were identified by interference in embryonating chicken eggs (ECE) with the production of hemagglutinin by the B-1 isolant of Newcastle disease virus (NDV). This interference test appears to be specific because the above interference was eliminated by adding type-specific anti-IBV serum to the IBV-NDV system; however, interference was not detectable when fowlpox virus (FPV) and infectious laryngotracheitis virus (LTV) were substituted for IBV. Specificity of the interference test was dependent upon a system involving IBV, NDV, FPV, and LTV. The test can be done in 3 days and requires minimum laboratory facilities. Most of the experiments were done with the Massachusetts type of IBV. Only a few were with the Connecticut type. The interfering action of the above two types of IBV over the B-1 isolant of NDV waxed between the 24th and 54th hr after inoculation of NDV; it was waning at the 54th-60th hr postinoculation and was undetectable by the 66th-72nd hr.