The impact of clinical pharmacy services in China on the quality use of medicines: a systematic review in context of China's current healthcare reform.
BACKGROUND
Recently, China initiated an ambitious healthcare reform aiming to provide affordable and equitable basic health care to all by 2020. To meet these goals, new policies issued by China's Ministry of Health mandate clinical pharmacy services be integrated into China's hospitals. This review aims to highlight the impact of clinical pharmacy services on the quality use of medicines in hospitals in China.


METHODS
Both English and Chinese databases were used. For the English databases, Web of Science, Medline, International Pharmaceutical Abstracts and Embase were searched using the following keywords ('pharmacists' OR 'pharmacy' OR 'pharmaceutical services/pharmaceutical care') AND ('China'). For the Chinese database, Chinese Biomedical Literature Database on disc was searched using the following keywords ('clinical pharmacist' OR 'clinical pharmacy' OR 'pharmaceutical care' OR 'pharmaceutical services'). Articles were then retrieved from WanFang database and China Knowledge Resource Integrated Database.


RESULTS
A total of 75 published papers were included in this review. The majority of studies were conducted in the inpatient setting (68%), which included clinical pharmacy interventions such as educating doctors and patients, evaluating and monitoring the implementation of hospital policies and/or reviewing medications on the ward. In the outpatient setting, the majority of studies conducted involved educating patients. Clinical pharmacy services frequently focused on antimicrobials (44%). More than half of these studies employed an administrative intervention alongside the clinical pharmacy service.


CONCLUSIONS
Clinical pharmacy services in China, with its unique healthcare system and cultural nuances, appear to positively influence patient care and the appropriate use of medications. From the published literature, it is expected that clinical pharmacy services can make a strong contribution to China's healthcare reform with further governmental and educational support.
Sydney Hospital and Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW, 2000 Australia Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, University of Sydney, Sydney, NSW, 2006, Australia Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China and School of Pharmaceutical Sciences, Department of Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Center, Beijing, 100083, China Sydney Hospital and Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW, 2000 Australia Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, University of Sydney, Sydney, NSW, 2006, Australia Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China and School of Pharmaceutical Sciences, Department of Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Center, Beijing, 100083, China jonathan.penm@sydney.edu.au.
Jonathan
J
Penm
Sydney Hospital and Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW, 2000 Australia Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, University of Sydney, Sydney, NSW, 2006, Australia Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China and School of Pharmaceutical Sciences, Department of Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Center, Beijing, 100083, China Sydney Hospital and Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW, 2000 Australia Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, University of Sydney, Sydney, NSW, 2006, Australia Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China and School of Pharmaceutical Sciences, Department of Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Center, Beijing, 100083, China.
Yan
Y
Li
Sydney Hospital and Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW, 2000 Australia Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, University of Sydney, Sydney, NSW, 2006, Australia Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China and School of Pharmaceutical Sciences, Department of Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Center, Beijing, 100083, China.
Suodi
S
Zhai
Sydney Hospital and Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW, 2000 Australia Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, University of Sydney, Sydney, NSW, 2006, Australia Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China and School of Pharmaceutical Sciences, Department of Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Center, Beijing, 100083, China.
Yongfang
Y
Hu
Sydney Hospital and Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW, 2000 Australia Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, University of Sydney, Sydney, NSW, 2006, Australia Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China and School of Pharmaceutical Sciences, Department of Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Center, Beijing, 100083, China.
Betty
B
Chaar
Sydney Hospital and Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW, 2000 Australia Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, University of Sydney, Sydney, NSW, 2006, Australia Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China and School of Pharmaceutical Sciences, Department of Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Center, Beijing, 100083, China.
Rebekah
R
Moles
D002681:China; D004358:Drug Therapy / Q000592:standards* / Q000706:statistics & numerical data; D018166:Health Care Reform; D006801:Humans; D010607:Pharmacy Service, Hospital; D015397:Program Evaluation; D011787:Quality of Health Care
China; Clinical pharmacist; clinical pharmacy; pharmaceutical care; pharmaceutical services