Methodological and reporting quality, risk of bias, and associated factors in systematic reviews of clinical pharmacy services: a meta-research study protocol

Objectives To assess the methodological quality, reporting quality, and risk of bias of systematic reviews (SRs) on clinical pharmacy services and to identify factors associated with these outcomes. Methods This meta-research study will include SRs, with or without meta-analysis, focused on pharmacist-led clinical services: medication review, medication therapy management, medication reconciliation, pharmacotherapeutic follow-up, disease management, drug monitoring, management of minor illness, and health education. A preliminary search was conducted in PubMed, Embase, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS), and the Cochrane Library from inception to 6 August 2025, without language or date restrictions. Searches will be rerun and updated after protocol publication. Two reviewers will independently perform study selection and data extraction. Methodological quality will be assessed using A MeaSurement Tool to Assess SRs 2, risk of bias using the Risk of Bias in Systematic Reviews tool, and reporting quality using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020) and PRISMA for Abstracts checklists. Analyses will summarize results and explore associations between study characteristics and quality indicators. The preliminary searches retrieved 4947 records after deduplication. This protocol has been registered with the Open Science Framework: osf.io/mg89h. Key findings This study is expected to provide a comprehensive overview of methodological rigor, reporting practices, and bias levels among SRs of clinical pharmacy services, identifying patterns and predictors of quality. Conclusions The study may guide improvements in transparency, reproducibility, and methodological standards, ultimately supporting higher-quality evidence to inform pharmaceutical care and policy.