A narrative review: Pharmacy intervention fidelity.

Abstract

There has been a significant increase in the literature surrounding community-based pharmacy interventions. However, less is known about how researchers assured these interventions were implemented consistently and faithfully to the established protocol. This narrative review aims to describe the nature and extent to which researchers reported intervention fidelity measures across depression and hypertension studies completed in community and ambulatory care settings. Two research assistants used defined literature search criteria to identify manuscripts involving community pharmacist interventions in hypertension or depression care management. These research assistants independently evaluated each manuscript based on the nature and extent to which the studies described intervention training to support intervention fidelity, the intervention structure and content, the tools used to document intervention fidelity, and the extent to which the intervention was performed as expected. Manuscript authors were contacted for clarification of any details not clear from their published works. Of the 6 depression and 19 hypertension manuscripts, intervention training was described in only 2 and 9 depression and hypertension manuscripts, respectively. Other depression and hypertension manuscripts did not describe such training or gave unclear training information. Respectively, only 2 and 9 of the depression and hypertension manuscripts described a tool that was used to capture interventions made according to protocol. Two of the depression manuscripts and 6 of the hypertension manuscripts were known to have measured the extent to which the intervention was performed as expected. There is considerable variability in the nature and extent that intervention fidelity measures are reported in the literature. Researchers should be required to report key intervention fidelity measures when seeking publication of their research. Such additional reporting of fidelity results will enable the scientific community to have greater confidence in study results, conclusions, and implications.