Mapping the characteristics of meta-analyses of pharmacy services: a systematic review

Background: Suboptimal meta-analyses with misleading conclusions are frequently published in the health areas, and they can compromise decision making in clinical practice. Aim of the review: This systematic review aimed to map the characteristics of published meta-analyses of pharmacy services and their association with the study conclusions. Method: We searched electronic databases (PubMed, Scopus, and Web of Science) to identify published meta-analyses of pharmacy services up to January 2019. Components of meta-analyses were extracted (i.e. studies’ metadata; methods used in the systematic review; description of the statistical model used for the meta-analysis; main results; conflict of interest and funding source). The methodological quality was evaluated using the R-AMSTAR tool. Results: A total of 85 meta-analyses were included, with 2016 as the median publication year. Overall, the methodological quality of meta-analyses of pharmacy services was considered suboptimal. Only one-third of authors registered a protocol; complete search strategy and raw data were provided by 55.3% and 9.4% of studies, respectively. Evidence strength (GRADE) was evaluated in only 19.2% of studies. PRISMA and Cochrane recommendations were stated to be followed in 60% and 27.4% of articles, respectively. Around half of studies performed sensitivity analysis, however, the prediction interval was presented by only one meta-analysis. Studies that favoured the pharmacists’ interventions poorly discussed the methodological quality and heterogeneity of primary trials. Conclusion: Poor conduction and reporting were observed in meta-analyses of pharmacy services, especially in those that favoured the pharmacist’s interventions. Reproducibility and transparency should be rigorously ensured by journal editors and peer-reviewers.