The practice of formally recognised advanced community pharmacists: A scoping review from global literature

Synthesised evidence on the formal recognition of advanced community pharmacists (ACPs) and their practice is limited. This review aims to explore global evidence on the practice of formally recognised ACPs.

This scoping review followed the JBI Manual for Evidence Synthesis and PRISMA guidelines. Advanced practice was determined using the International Pharmaceutical Federation framework encompassing four pillars: professional practice, leadership, research, and education. Formal recognition referred to post-registration acknowledgement by authorised bodies. Twelve databases and Google Scholar were searched between 2004 and 2024, without country or language restrictions. Findings were thematically analysed using NVivo 14.

Sixty-three studies from six high-income countries were included, predominantly from Canada (n = 18) and the United States (n = 16). Formally recognised ACPs provided clinical services including prescribing (n = 27), vaccination (n = 22), and medication review (n = 20). Few studies reported ACPs practice within the research and education pillars. There was variation in the definition and formal recognition mechanisms of ACPs between studies. In addition, many studies reported practice corresponding to advanced services but did not describe prerequisite training or formal recognition. Reported challenges included inadequate remuneration, limited access to patient records, and low stakeholder awareness. Key facilitators were availability of formal recognition, interprofessional relationships, and appropriate training.

ACPs have expanded public access to clinical services. However, formal recognition and practice of ACPs from low-middle-income-countries are underrepresented in the literature. More work is needed to recognise ACPs' practice in education and research. Future research should clearly operationalise advanced practice within existing frameworks, explicitly report recognition mechanisms, and engage broader stakeholders in the implementation, evaluation, and role development of ACPs.