BACKGROUND: Insomnia is a common sleep disorder that affects a large portion of the population in a situational, recurrent, or chronic way. In Canada, it is estimated that 13% of the population suffers from it.
OBJECTIVE: The primary objective of this literature review is to identify and describe studies dealing with the role and impact of the management of insomnia by a pharmacist.
METHODS: PubMed®, EMBASE® and CINALH Complete were searched to extract articles published between January 1st, 1990 and May 28, 2020. Studies on the role and impact of management of insomnia by a pharmacist, in French and English, descriptive or quantitative, with or without control group were included. Articles that did not deal with insomnia as the primary topic or where insomnia is a secondary condition were excluded, conference abstracts and studies showing no concrete results. The following variables were extracted: author, type of study, duration, location, sample size and characteristics of participants, description of pharmacist interventions, limits and biases, outcomes assessed and results. The quality of the pharmacists\' interventions description was evaluated with DEPICT2.
RESULTS: Our review identified eight articles published from 2006 to 2018 evaluating 14 types of outcomes and 41 separate outcomes. A total of 37% (7/19) of the quantitative outcomes had statistically significant positive results, regarding insomnia qualification, symptoms and adequate use. Six studies were conducted in community pharmacy. The quality score varied between 8 and 10 out of 11.
CONCLUSIONS: There is little data on the role and impact of the management of insomnia by a pharmacist. The pharmacist can have a positive impact, particularly when practicing in a community pharmacy. Given the limited data and the prevalence of insomnia, it appears relevant to invest in pharmaceutical evaluative research for this condition.

BACKGROUND: There is more and more evidence about the roles and impacts of the pharmacist. Health decision makers, managers, clinicians and patients need evidence to support an appropriate allocation of funds to different models of practice.
OBJECTIVE: The main objective is to present an inventory of the roles and impacts of pharmaceutical activity in the international literature.
METHODS: Review of literature. The articles related to the pharmacist\'s roles and impacts were selected according to a reproducible research strategy from 1990 to the present day (French/English with description of the intervention and impacts, where applicable) and a standard operating procedure. The following variables were extracted: author, country, specifications, pharmaceutical activities, care programs, targeted pathologies, impacts according to eight markers (mortality, morbidity, costs, adverse events, medication errors, compliance, satisfaction, others) and quality score. Only descriptive statistics were performed.
RESULTS: As of February 1st, 2019, we recorded 2424 articles divided into 100 subjects (41 pharmaceutical activities, 30 pathologies, 29 care programs). Studies come from the United States (46.66%), multiple countries (8.00%), Canada (7.67%), France (6.06%), the United Kingdom (5.19%), Australia (3.50%) and other countries (22.92%). Studies are cross-sectional (47.55%), retrospective (33.68%) and prospective (17.87%) or non-categorized (<1%). The markers associated with the pharmacist\'s activity concern morbidity (23.12%), medication errors (11.82%), satisfaction (7.13%), compliance (6.06%), costs (5.47%), adverse events (3.74%), mortality (1.36%), and other indicators (41.31%). The studies have 6763 descriptive parameters and 5224 impact parameters (60.42% are positive, 38.55% are neutral and 1.03% are negative).
CONCLUSIONS: This literature review confirms the roles and impacts of the pharmaceutical activity both in the pharmacy and in the hospital. A majority of the pharmaceutical interventions studied have positive impacts. It is essential to consider evidence about the roles and impacts of the pharmaceutical activities to take full advantage of the pharmacist\'s expertise in healthcare.

OBJECTIVE: The main objective of this study was to compare the responses of pharmacy residents regarding critical steps for medication order review, in the presence or absence of clinical pharmacists on patient care units, to describe the sequence of these steps and to compare them to an optimal sequence. The secondary objectives were to test this sequence in a simulation and to assess the residents\' level of agreement on medication order review.
METHODS: Twenty-two validation steps were selected from guidelines. A simulation on order review was organized in three steps: selecting elements judged to be necessary or not for the order review critical path, then organizing this sequence in chronological order, implementation of this critical path on two simulated practical cases, resident perceptions about order review in their training.
RESULTS: Forty-one residents participated in the activity. Responses were heterogeneous regarding the elements\' sequence and the time required for the review of a simulated case (3-13minutes). A majority of residents considered that their training was insufficient (29/41), that pharmacists validated differently (27/41), and that it was impossible to review the 22 proposed items for each prescription (30/41).
CONCLUSIONS: This article highlights heterogeneous medication order review practices among pharmacy residents, due to a lack of training in their curriculum according to them. It is essential to acquire medication order review standard both locally and nationally.