Repeat dispensing of prescriptions in community pharmacies: a systematic review of the UK literature

摘要

Objective To identify, review and evaluate the published literature that focused on the impact of repeat dispensing in community pharmacies in the United Kingdom. Method Electronic databases (e.g. Medline, Embase and CINAHL) were searched from 1992 to May 2005. This was supplemented by searching PJ-online, IJPP online conference abstracts and the bibliographies of retrieved articles. Analysis of the findings explored the quality of the assessed papers, stakeholders' perceptions of repeat dispensing, the impact on professional relationships and workload, quality of care and prescription cost savings. Key findings Four randomised controlled trials (RCTs) and one before-and-after study were identified; most studies also incorporated a qualitative component. The findings indicated that patients' satisfaction with repeat dispensing was high, mainly as the service was seen as more convenient and time saving. While pharmacists considered that their relationship with patients had improved, one study found that patients did not necessarily agree and considered that pharmacists still remained in their dispensaries. Quality of care was considered in two RCTs, which indicated that more adverse reactions and compliance issues were identified in the intervention group. However, no direct comparisons were reported in differences in rates between intervention and control groups. Likewise, it was not possible to determine if any of the reported cost savings were solely attributable to repeat dispensing, as direct comparisons between groups were not reported. Conclusions:Definitive conclusions about the effectiveness and impact of repeat dispensing are difficult to draw given a lack of transparency and systematicity when reporting these studies. Nevertheless, the findings suggest that there are high levels of patient satisfaction with the service. Likewise, it was not possible to draw conclusions about the possible savings on the NHS drug budget. Important policy decisions are being made about the implementation of repeat dispensing; however they are currently been made in a vacuum of adequate information.