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• W2004579604 abstract "Evidence from systematic reviews and meta-analysessupport the provision of pharmacy services to a range ofpatient groups. This includes patient groups with highburden conditions such as diabetes, asthma, hypertensionand hyperlipidaemia [1]. Evidence is an important factorthat guides the development and delivery of new clinicalpharmacy services. In the context of finite resources, tar-geting clinical pharmacy services to patient groups withdemonstrated benefits is consistent with the principles ofevidence-based decision making.It is widely stated in science, however, that ‘absence ofevidence is not evidence of absence’. Vulnerable patientgroups, such as those with dementia, refugees, and theculturally and linguistically diverse (CALD) are under-represented in pharmacy practice research. These vul-nerable patient groups are often at high risk of adverse drugevents (ADEs). The provision of clinical pharmacy ser-vices for people with intellectual disability (ID) is an ex-cellent example.In this issue of IJCP, O’Dwyer et al. [2] present a nar-rative review of pharmacy services for people with intel-lectual disability. The conclusions that can be drawn from aliterature review are usually dependent on the quality of theincluded studies. This review is equally important for whatis not included. O’Dwyer et al. identified no randomised ornon-randomised controlled studies of pharmacist services.The two intervention studies were conducted in a singleinstitution [3, 4]. Three of the six reports of pharmacistparticipation in service provision for people with ID werepublished more than 35 years ago [5–7].As acknowledged by O’Dwyer et al., the lack of pub-lished research does not necessarily reflect lack of serviceprovision [2]. It is possible that clinical pharmacists havenot documented the services they provide. While examplesof innovative practice undoubtedly exist, the lack ofpractice-based research to inform service delivery remainsa concern [8]. This is particularly true given the high ratesof psychotropic use, frequent off-label prescribing, andminimal evidence for medication efficacy [9, 10]. Althoughthere is currently no rigorous body of evidence to supportprovision of clinical pharmacy services to people with ID,extrapolation of evidence from other clinical areas suggeststhat benefits are likely [11]. Furthermore, a recent an-tipsychotic discontinuation study reported that nearly halfof participants with ID achieved complete discontinuationand this was associated with improved behavioural func-tioning [12].Twenty-five years ago Hepler and Strand called on thepharmacy profession to mature ‘by accepting its socialresponsibility to reduce preventable drug-related mor-bidity and mortality’ [13]. There is an urgent need for thepharmacy profession to develop a research agenda topromote the quality use of medications in vulnerablepatient groups. In the interim, however, there is a socialresponsibility to target services to vulnerable patientgroups at high risk of ADEs for whom minimal evidencecurrently exists." @default.
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• W2004579604 date "2015-04-24" @default.
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• W2004579604 title "Balancing evidence and social responsibility when targeting clinical pharmacy services: the example of people with intellectual disabilities" @default.
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• W2004579604 doi "https://doi.org/10.1007/s11096-015-0117-0" @default.
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