A systematic review of pharmacist input to metabolic syndrome screening, management and prevention.

Al AdAwi, Rana Moustafa; Stewart, Derek; Ryan, Cristin; Tonna, Antonella Pia

Abstract

Metabolic syndrome is a cluster of factors that increase the risk of cardiovascular disease and include: diabetes and prediabetes, abdominal obesity, elevated triglycerides, low high-density lipoprotein cholesterol and high blood-pressure. However, the role of the pharmacist in the metabolic syndrome has not yet been fully explored. This systematic review aimed to critically appraise, synthesise, and present the available evidence on pharmacists’ input to the screening, prevention and management of metabolic syndrome. The final protocol was based on the “Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P)”. Studies published in English from January 2008 to March 2020, reporting any pharmacist activities in the screening, prevention or management of metabolic syndrome were included. Databases searched were Medline, Cumulative Index to Nursing and Allied Health Literature, International Pharmaceutical Abstracts, Cochrane and Google Scholar. Studies were assessed for quality by two researchers, data extracted and findings synthesised using a narrative approach. Of the 39,430 titles reviewed, ten studies were included (four were randomised controlled trials). Most studies focused on pharmacist input to metabolic syndrome screening and management. Screening largely involved communicating metabolic parameters to physicians. Management of metabolic syndrome described pharmacists collaborating with members of the multidisciplinary team. A positive impact was reported in all studies, including achieving metabolic syndrome parameter goals, reverting to a non-metabolic syndrome status and, improved medication adherence. The populations studied were paediatrics with risk factors, adults with comorbidities and psychiatric patients. Integration of the pharmacist within the multidisciplinary team, an easy referral process and accessibility of service were potential facilitators. Inadequate funding was the key barrier. The studies describing pharmacist input in metabolic syndrome provide limited evidence of positive outcomes from screening and management as part of collaborative practice. Further work is required to provide more robust evidence of effectiveness and cost-effectiveness while considering key barriers.

Citation

AL ADAWI, R.M., STEWART, D., RYAN, C. and TONNA, A. 2020. A systematic review of pharmacist input to metabolic syndrome screening, management and prevention. International journal of clinical pharmacy [online], 42(4), pages 995-1015. Available from: https://doi.org/10.1007/s11096-020-01084-3

• Journal Article Type: Review
• Acceptance Date: Jun 11, 2020
• Online Publication Date: Jun 30, 2020
• Publication Date: Aug 31, 2020
• Deposit Date: Jun 16, 2020
• Publicly Available Date: Jun 16, 2020
• Journal: International journal of clinical pharmacy
• Print ISSN: 2210-7703
• Electronic ISSN: 2210-7711
• Publisher: Springer
• Peer Reviewed: Peer Reviewed
• Volume: 42
• Issue: 4
• Pages: 995-1015
• DOI: https://doi.org/10.1007/s11096-020-01084-3
• Keywords: Pharmacist role; Pharmacists; Metabolic syndrome; Screening; Management; Prevention; Systematic review
• Public URL: https://rgu-repository.worktribe.com/output/932879