Patient health outcomes for evaluation of pharmacist-led primary care: a scoping review

Pharmacists' role in primary care has rapidly evolved in recent years, driven by pressures on primary care and supported by increased government funding, further enabling full scope of practice while reducing patient costs. To optimize healthcare delivery, the patient outcomes of pharmacist-led primary care in community settings must be evaluated.

This scoping review aimed to identify and explore the breadth of patient health outcomes used to assess the quality, effectiveness, and safety of pharmacist-led primary care.

A comprehensive search was conducted in four databases and Google for articles published from 1997 to July 2023, updated in February 2025. Database records were screened independently by two reviewers at two stages in Covidence. Google search results were screened by one reviewer, with selections verified by a second reviewer. Studies were included if they involved pharmacist-led primary care and reported patient health outcomes related to quality, effectiveness, and/or safety. Extracted data on study design, disease state, clinical services, and patient outcomes were categorized by two reviewers. Data are reported descriptively (frequencies, percentages) and are displayed using heat maps. Results were reported using PRISMA-ScR guidelines.

A total of 299 studies (297 peer-reviewed, 2 grey literature) were included from 10,498 database records and 300 grey literature search results. Experimental study designs were the most common (61%) and increased in prevalence over the study period. Patient populations primarily comprised those with chronic diseases, primarily endocrine (27%) and cardiovascular (26%), with the volume of studies focused on these groups also increasing over time. Studies often evaluated multiple types of clinical service, with more focusing on education or counselling (29%) and chronic disease management (23%). A wide variety of outcomes were measured, with more than 70% being positive. The number of studies reporting outcomes increased markedly after 2002, particularly those examining clinical measures (29%), resource use (19%), and laboratory measures (14%).

This scoping review identified patient health outcomes used to evaluate pharmacist-led primary care. Although studies on pharmacist-led clinical services have increased, the most assessed services may not reflect current practice. These findings should inform health system metrics grounded in outcomes that matter to patients to ensure safe, effective pharmacist-led care.