Methods: The protocol was registered in the International Prospective Register of Systematic Reviews database (PROSPERO: CRD42022322558). The databases Medline, Embase, PsycINFO and CINAHL were searched and supplemented by grey literature searches, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist. In total, 338 titles and abstracts were screened, 20 studies underwent full-text screening and four studies met the inclusion criteria and underwent quality assessment. The results are reported narratively due to the heterogeneity of study designs.
Results: There was some evidence for the effectiveness of interventions, resulting in increased provision of consumer self-help advice and materials, referrals to other care providers, and an increase in staff knowledge and confidence in continence care. Evidence was inconclusive for clinical outcomes due to small sample sizes and poor follow-up rates. Acceptability of interventions to both pharmacy staff and consumers was generally positive with some frustrations with reimbursement procedures and time constraints. Facilitators of a successful pharmacy-based continence service are likely to include staff training, high-quality self-care resources, increased public awareness, and the establishment of effective referral pathways and appropriate reimbursement (of service providers).
Conclusions: There is a paucity of evidence regarding the contribution of the community pharmacy sector to continence care. The development of a new pharmacy bladder and bowel service should involve patients, healthcare professionals and policy stakeholders to address the potential barriers and build upon the facilitators identified by this review.
Alan Uren,1,2 Shoba Dawson,3 Nikki Cotterill,1 Ade Williams,4 Hugh McLeod,5,6 David Chandler, Margaret Watson,7,8
- School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Blackberry Hill, Bristol
- Bristol Urological Institute, Southmead Hospital, Bristol, UK
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
- Bedminster Pharmacy Bristol, BS3 1BN
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Watson Research and Training Limited, Aberdeen, AB15 8FL
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 160 Cathedral Street, Glasgow, G4 0RE