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Pharmacist prioritization tools for paediatric patients: development, implementation, validation, and impact-a
Elena Van Nederkassel1,2, Elisabeth Van Eyken1,2, Ine Hubrechts1,2
1School of Pharmacy, University College London (UCL), 29-39 Brunswick Square, London WC1N 1AX, United Kingdom.
Insights
Few pharmacist prioritization tools exist for pediatric patients, with most still in development. These tools show potential for improving workflow and pharmacist interventions but require further validation and implementation research.
Area of Science:
- Pharmacy practice
- Clinical pharmacy
- Pediatric pharmacotherapy
Background:
- Pharmacist prioritization tools aid in identifying patients for targeted interventions.
- Existing reviews of these tools have largely excluded pediatric populations.
- There is a need to understand tools specifically for clinical pharmacists in pediatric settings.
Purpose of the Study:
- To systematically identify and describe prioritization tools for clinical pharmacists in pediatric settings.
- To analyze the development, validation, and impact of these tools.
- To explore barriers to the implementation of pediatric pharmacist prioritization tools.
Main Methods:
- A comprehensive search of MEDLINE, Embase, and International Pharmaceutical Abstracts was conducted.
- Empirical study types, including conference abstracts, were included without date or language restrictions.
- Quality assessment was performed using the Delphi Critical Appraisal Tool or Mixed Methods Appraisal Tool.
Main Results:
- Few tools (3 full-text papers, 5 abstracts) were identified, mostly in the testing phase.
- Group consensus among pharmacists and technicians was a common development method.
- Limited validation and generalizability were noted; few tools were implemented in routine practice, though some showed potential for workflow improvement.
Conclusions:
- Existing pediatric pharmacist prioritization tools are scarce and largely in early development stages.
- These tools demonstrate potential to enhance pharmacy workflows and enable timely, targeted interventions.
- Future research should prioritize tool validation, multidisciplinary development, and patient/carer involvement.
Objectives:
Tools have been developed to help pharmacists identify which patients to prioritize but reviews of these tools have not focused on paediatrics. This systematic review aimed to identify prioritization tools developed for clinical pharmacists in paediatric settings, describe their development, validation, and impact, and explore the barriers to their implementation.
Methods:
MEDLINE, Embase, and International Pharmaceutical Abstracts were searched without language or date restrictions. All empirical study types investigating prioritization tools for clinical pharmacists in paediatrics (≤18 years), including conference abstracts, were included. Quality was assessed using either the Delphi Critical Appraisal Tool or the Mixed Methods Appraisal Tool as appropriate for the study design.
Key Findings:
Three full-text papers and five conference abstracts were included. Most tools were in the testing phase and varied in format. Group consensus of pharmacists was the most common development method, as well as pharmacy technicians in some studies. Only one study assessed and reported significant associations between prioritization scores and clinical outcomes. Several tools were reported to reduce the need for manual chart review, avoid duplicative reviews, or support the identification of patients requiring pharmacist review based on observed workflow changes or end-user feedback during pilot testing or implementation. Overall, the tools lacked formal validation and external generalizability, and few were implemented in routine practice.
Conclusion:
Few pharmacist prioritization tools for paediatrics exist, and most remain in the testing stages. However, they show the potential to improve workflows and support timely, targeted pharmacist interventions. Future research should focus on validation, multidisciplinary development, and the involvement of patients and carers in their development.
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