A systematic review and meta-analysis of pharmacy education and practice on prevention and management of noncommunicable diseases in ASEAN countries

Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality in ASEAN countries. However, consolidated evidence regarding the effectiveness of pharmacy practice interventions in ASEAN is still unclear. This study aimed to explore the scope and impact of pharmacy practice in managing NCDs in ASEAN countries. Systematic searches were conducted in 12 databases (PubMed™, Science Direct™, Scopus™, Springer Link™, Web of Science™, Cochrane Library™, and other databases) for studies published between 2001 and 2021. Of the 171 included studies from seven countries, seven focused on pharmacy education and showed improvements in students' knowledge and skills. Meta-analyses were performed on 47 randomized controlled trials using a random-effects models and risk of bias assessment. Pharmacists' interventions significantly improved fasting blood glucose, HbA1c, lipid parameters, blood pressure, and percent peak expiratory flow rates, compared to usual care. No significant improvements were found in blood pressure (particularly in diabetes subgroups), smoking cessation, or body weight. Positive humanistic outcomes, such as patient satisfaction, knowledge, and quality of life, were reported. While the studies in the meta-analyses were limited to Thailand, Malaysia, Indonesia, and Lao PDR, pharmacists' practice interventions in ASEAN countries demonstrated positive impacts on both clinical and humanistic outcomes. Due to a high overall risk of bias, the results should be interpreted with considerable caution. Further large-scale, long-term, and rigorous studies should be undertaken.Systematic review registration: The Prospective Registration of Systematic Review on April 10, 2022, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=316184 .