Do researchers use pharmacists' communication as an outcome measure? A scoping review of pharmacist involvement in diabetes care.

Objectives: Pharmacy practice increasingly revolves around obtaining and interpreting information. We investigated whether and how pharmacy practice researchers design their studies in ways that acknowledge verbal communication between pharmacists and patients with diabetes.

Methods: We conducted a scoping review of pharmacists' interventions with patients previously diagnosed as having diabetes with the aim of assessing how many used communication (quality and quantity) as an outcome measure. A scoping review identifies gaps in the literature and draws conclusions regarding the overall state of a research programme, but does not necessarily identify gaps in the quality of the studies reviewed. Quality assessment, therefore, was not conducted. MEDLINE, EMBASE, the Cochrane Library and International Pharmaceutical Abstracts were searched from 2003 to 2008 to identify relevant studies published in English. Reference lists of key studies were also scanned to identify additional studies. Randomized controlled trials and related studies of pharmacists verbal communication with diabetic patients were included.

Key Findings: Some 413 abstracts were identified through database and reference searching. Of these, 65 studies met abstract inclusion criteria and 16 studies met full-text inclusion criteria necessary for this review. The majority of included studies report on patients' health outcomes, beliefs about drugs, self-reported health-related quality-of-life scales or some combination of these measures as indicators of pharmacists' interventions. Nine studies included information on the duration of the initial interaction between pharmacists and patients with diabetes; 13 reported on the number of follow-up contacts with pharmacists, and seven studies indicated that pharmacists participating in interventions had received training in diabetes management or in patient-centred care. No studies included or evaluated transcripts of pharmacist-patient interactions.

Summary: Results reveal a gap in the existing literature. In studies of diabetes, pharmacy practice researchers do not appear to consider the influence of pharmacists' communication skills on health outcomes. Future studies should be designed to incorporate a communication research component.