How are community pharmacist-led health screening services evaluated? A scoping review using the RE-AIM framework.

BACKGROUND

Community pharmacists increasingly deliver health screening services that expand access to preventive care and early disease detection. However, evaluation practices vary substantially, limiting comparison across studies and the development of implementation-ready evidence.

OBJECTIVE

To describe how community pharmacy-based screening services have been evaluated and to propose priorities for more complete, sustainable, and transparent evaluation.

METHODS

Medline, APA PsycINFO, and International Pharmaceutical Abstracts were searched for English-language reports published from January 1, 2004, through October 13, 2024. Eligible reports described a pharmacist-led screening service in a community pharmacy and included an evaluation component. Two reviewers conducted study selection, data extraction, and quality appraisal using the Mixed Methods Appraisal Tool. Findings were synthesized descriptively using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework; a domain was coded when at least one explicitly reported indicator corresponded to that domain.

RESULTS

Of 749 unique records, 57 reports representing 50 unique studies were included. Cohort designs were most common (76%), and 90% of studies were conducted in Europe, North America, or Australia. At least one effectiveness-related RE-AIM indicator was reported by 96% of studies, compared with implementation (90%), reach (86%), adoption (74%), and maintenance (60%). Eleven studies (22%) used a theory, framework, model, evaluation standard, or reporting guideline. Recruitment strategies were described by 98% of studies, but only 6% evaluated recruitment yield or representativeness. Staff training was reported by 82%, whereas 14% assessed a training outcome.

CONCLUSIONS

Evaluations of community pharmacy-based screening services commonly reported short-term effectiveness-related outcomes, but comprehensive assessment of adoption, implementation fidelity, organizational maintenance, recruitment performance, and training outcomes was uncommon. The heterogeneity of interventions and study designs, coupled with the lack of a formal effectiveness synthesis, limits the ability to draw conclusions about comparative or long-term effectiveness. Future evaluations should use clearly operationalized implementation indicators, report the full screening and referral pathway, distinguish individual-from organizational-level maintenance, and assess equity, harms, implementation costs, and long-term service continuation.