Pharmacist prioritization tools for paediatric patients: development, implementation, validation, and impact—a systematic review

OBJECTIVES: Tools have been developed to help pharmacists identify which patients to prioritize but reviews of these tools have not focused on paediatrics. This systematic review aimed to identify prioritization tools developed for clinical pharmacists in paediatric settings, describe their development, validation, and impact, and explore the barriers to their implementation. METHODS: MEDLINE, Embase, and International Pharmaceutical Abstracts were searched without language or date restrictions. All empirical study types investigating prioritization tools for clinical pharmacists in paediatrics (≤18 years), including conference abstracts, were included. Quality was assessed using either the Delphi Critical Appraisal Tool or the Mixed Methods Appraisal Tool as appropriate for the study design. KEY FINDINGS: Three full-text papers and five conference abstracts were included. Most tools were in the testing phase and varied in format. Group consensus of pharmacists was the most common development method, as well as pharmacy technicians in some studies. Only one study assessed and reported significant associations between prioritization scores and clinical outcomes. Several tools were reported to reduce the need for manual chart review, avoid duplicative reviews, or support the identification of patients requiring pharmacist review based on observed workflow changes or end-user feedback during pilot testing or implementation. Overall, the tools lacked formal validation and external generalizability, and few were implemented in routine practice. CONCLUSION: Few pharmacist prioritization tools for paediatrics exist, and most remain in the testing stages. However, they show the potential to improve workflows and support timely, targeted pharmacist interventions. Future research should focus on validation, multidisciplinary development, and the involvement of patients and carers in their development.