Study registration
The review protocol was registered with the International prospective register for systematic review (PROSPERO database; registration number CRD42020165363). The review was guided by the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions [29]. The reporting of the review complies with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement [30].
Eligibility criteria for study inclusion
The search was focused on locating studies eligible for inclusion or excluded based on the criteria below:
Inclusion Criteria
- Only primary studies (qualitative, quantitative and mixed studies);
- Studies which have tested an intervention and/or have obtained views of stakeholders (pharmacists, GPs, medical specialists, practice staff and patients) related to SCA in the primary care setting.
- Studies in which a pharmacist has input within a primary care setting to provide non-dispensing care
Exclusion criteria
- Studies in which the intervention has been provided only in secondary or tertiary care settings (hospitals, specialist clinics and national and regional specialist centre) ;
- Studies written in a language other than English;
- Studies presented as editorials, protocols, and commentaries.
Information sources and search strategy
The following eleven databases were systematically searched from date of inception to January 2020: Allied and Complementary Medicine Database (AMED®), (1985 to 11.01.2020) Platform: Ovid®, Cumulative Index to Nursing and Allied Health Literature (CINAHL®), (1950 to 11.01.2020) Platform: EBSCO®. Cochrane Database of Systematic Reviews (CDSR), (accessed on 11.01.2020) Platform: Wiley® online library, Excerpta Medica database (EMBASE®), (1974 to 11.01.2020) Platform: Ovid®, EMCARE®, (1995 to 11.01.2020) Platform: Ovid®, Google Scholar, (accessed on 11.01.2020) Platform: Google UK®, Healthcare Management Information Consortium (HMIC®), (1979 to September 2019) Platform: Ovid®, Medical Literature Analysis and Retrieval System Online (MEDLINE®), (1946 to 11.01.2020) Platform: Ovid®. PsycINFO®, Psychology and Behavioural Sciences Collection, Health Business Elite, Biomedica Reference Collection: Comprehensive Library, Information Science & Technology Abstracts, (1967 to 11.01.2020) Platform: EBSCOhost®. Scopus, (2004 to 11.01.2020) Platform: Elsevier, Web of Science® Core Collection, (1970-11.01.2020) Platform: Clarivate Analytics®. The search was adapted according to the respective database-specific search tools. It was searched using a combination of medical subject heading terms (MeSH), free-text search terms and Boolean operators. Refer to supplementary information S1 ‘Search terms’ for specific detail of search used for each database. Search results in languages other than English were noted, but for practical reasons, only search results in English, or translated into English, were included in this review. In an effort to identify unpublished studies, a search of grey literature was performed (http://www.opengrey.eu/ on 11.01.2020) to identify studies not indexed in the databases listed above.
Data collection and analysis
All references from database search were downloaded into Endnote® X8.2 [31] reference manager which was used to collate and remove duplicate records, and to screen titles, abstracts and store the full text of retrieved studies. Citations from OpenGrey could not be uploaded to Endnote® reference manager and therefore were uploaded to a Microsoft Excel® 2016 spreadsheet. Duplicate citations were removed by the automatic de-duplicating option in EndNote®X8.2 and were supplemented by hand-searching. Two researchers (NI) and (CH) examined titles and abstracts of all eligible articles according to the inclusion and exclusion criteria listed above. References to be screened were allocated into groups and was divided into ‘Include’, ‘exclude’ and ‘potential’ groupsets. The full-text articles of any abstracts classified as potentially meeting the inclusion criteria were retrieved and analysed independently by two authors (NI and CH) against predefined inclusion and exclusion criteria with differences resolved by the research team consensus from the research team. Principal authors of all included papers were contacted to explore the potential for any studies considered vital to them that may have been missed in our search strategy. A data extraction form from the Cochrane collaboration was utilised to extract data from eligible papers [32]. Raw data from qualitative studies were extracted onto Microsoft Excel® 2016 spreadsheet.
If data could not be pooled for meta–analysis, the plan was to undertake a narrative synthesis of results. The qualitative data synthesis methodology was decided upon after the quantity, quality, conceptual richness, and contextual thickness of the qualitative studies was determined.
The Mixed Method Appraisal Tool (MMAT) 2018 version was used to appraise and describe the methodological quality of included quantitative, qualitative and mixed-method studies. A pilot test of two articles was conducted to ensure consistent interpretation between the NI and CH. Discrepancies were resolved through discussion and consensus with the research team. If further information was required to appraise a particular study, an attempt was made to contact the authors by phone or email. Quality scores will be calculated using the MMAT tool. However, this did not solely determine if studies are of “low” or “high” quality, as a descriptive summary using MMAT criteria was considered [33]. If a study received a low score, it was compared with those with a higher score (higher quality studies) to consider if this modifies the outcome and interpretation of our synthesis.