U.S. Pharmacists' Effects as Team Members on Patient Care: Systematic Review and Meta-Analyses
Chisholm-Burns MA, JK Lee, CA Spivey, M Slack, R Herrier, E Hall-Lipsy, J Graff Zivin, I Abraham, J Palmer, JR Martin, S Kramer, and T Wunz, “U.S. Pharmacists' Effects as Team Members on Patient Care: Systematic Review and Meta-Analyses,” Medical Care, 48(2010): 923-933.
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Background: One approach postulated to improve the provision of health care is effective utilization of team-based care including pharmacists.
Objective: The objective of this study was to conduct a comprehensive systematic review with focused meta-analyses to examine the effects of pharmacist-provided direct patient care on therapeutic, safety, and humanistic outcomes.
Methods: The following databases were searched from inception to January 2009: NLM PubMed; Ovid/MEDLINE; ABI/INFORM; Health Business Full text Elite; Academic Search Complete; International Pharmaceutical Abstracts; PsycINFO; Cochrane Database of Systematic Reviews; National Guideline Clearinghouse; Database of Abstracts of Reviews of Effects; ClinicalTrials.gov; LexisNexis Academic Universe; and Google Scholar. Studies selected included those reporting pharmacist provided care, comparison groups, and patient-related outcomes. Of these, 56,573 citations were considered. Data were extracted by multidisciplinary study review teams. Variables examined included study characteristics, pharmacists’ interventions/services, patient characteristics, and study outcomes. Data for meta-analyses were extracted from randomized controlled trials meeting meta-analysis criteria.
Results: A total of 298 studies were included. Favorable results were found in therapeutic and safety outcomes, and meta-analyses conducted for hemoglobin A1c, LDL cholesterol, blood pressure, and adverse drug events were significant (P 0.05), favoring pharmacists’ direct patient care over comparative services. Results for humanistic outcomes were favorable with variability. Medication adherence, patient knowledge, and quality of life-general health meta-analyses were significant (P 0.05), favoring pharmacists’ direct patient care. Conclusions: Pharmacist-provided direct patient care has favorable effects across various patient outcomes, health care settings, and
disease states. Incorporating pharmacists as health care team members in direct patient care is a viable solution to help improve US health care.
