A systematic review of pharmacists' input in the screening, management and prevention of metabolic syndrome

Abstract

Objectives: To critically appraise, synthesise, and present the available evidence on pharmacists' input to the screening, prevention and management of metabolic syndrome (MetS). Design: Systematic review. Methods: The protocol was developed based on the 'Preferred Reporting Items for Systematic review and Meta-Analysis Protocols'. Studies published in English from January 2008 to December 2018 reporting any pharmacist activities in the screening, prevention or management of MetS were included. The search was conducted in Medline, Cumulative Index to Nursing and Allied Health Literature, International Pharmaceutical Abstracts and Cochrane. Studies were assessed for quality by two researchers, data extracted and ndings synthesized using a narrative approach. Results: Nine studies were included in the review, with four being randomised controlled trials. Most studies focused on pharmacist input to MetS screening and management. Screening largely involved communicating metabolic parameters to physicians. Studies involving the management of MetS described pharmacists collaborating with physicians and other health professionals. The positive impact was reported in all studies. These included achieving MetS parameter goals, reverting to a non-MetS status, improved medication adherence and self-reported improved lifestyle modification. The populations studied were paediatrics with risk factors and adults with comorbidities and psychiatric patients. Integration within the multidisciplinary team, an easy referral process and accessibility service were potential facilitators and inadequate funding the key barrier. Conclusion: The limited number of studies describing pharmacist input in MetS provides some 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