Robust management of chronic conditions is crucial in mitigating the burdens associated with these illnesses. To ensure pharmacists are adequately equipped for their role in chronic disease management (CDM), targeted programs that enhance their knowledge, practical abilities, and professional attitudes are necessary. As such, there is a clear need for a thorough, current review to assess the impact of such programs and explore avenues for further advancement. Classifying these programs according to the Effective Practice and Organization of Care (EPOC) framework is key to offering more effective guidance for health policy development. This systematic review aimed to pinpoint programs aimed at boosting pharmacists' abilities in CDM using the EPOC classification and to evaluate their overall impact. In line with the Cochrane Handbook protocols, searches were carried out through April 2024 across MEDLINE and Scopus databases. Studies were selected if they were English-language randomized controlled trials (RCTs) focused on interventions for pharmacists and evaluating outcomes related to knowledge, skills, or attitudes in CDM contexts. Bias risks were evaluated via the Cochrane RoB 2 instrument for individual or cluster RCTs. Results were synthesized narratively, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
A total of 11 RCTs were selected, covering diverse CDM elements in both community and hospital pharmacy settings. The programs fell into categories of implementation strategies alone or in combination with delivery arrangements. Six programs using solely implementation strategies showed reliable positive effects, with improvement scores between 0.99 and 9.17 (p < 0.05). Two additional implementation strategy programs, however, had variable outcomes, lacking notable gains in knowledge or skills. Combined approaches in two cases demonstrated gains, with percentage improvements from 4.5% (95% CI: 1.6%-7.4%) to 30% (95% CI: 29%-40%), while one combined program yielded no notable change. Bias risks varied considerably among the reviewed studies. Programs centered on implementation strategies, whether standalone or paired with delivery arrangements, contributed to better pharmacist performance in CDM. The bulk of these efforts produced meaningful advances in knowledge, skills, and attitudes among pharmacists. Such evidence highlights the value of customized programs focused on building competencies to strengthen pharmacists' contributions to CDM. These results can inform policymakers in formulating regulations and strategies to support lifelong learning and professional growth in pharmacy practice.
