US Pharmacists' Effect as Team Members on Patient Care: Systematic Review and Meta-Analyses.
Chisholm-Burns, Marie A. PharmD, MPH, FCCP, FASHP *+; Kim Lee, Jeannie PharmD, BCPS *; Spivey, Christina A. PhD, LMSW *; Slack, Marion PhD *; Herrier, Richard N. PharmD *; Hall-Lipsy, Elizabeth JD, MPH ++; Graff Zivin, Joshua PhD [S]; Abraham, Ivo PhD, RN *; Palmer, John MD, PhD [P]; Martin, Jennifer R. MA [//]; Kramer, Sandra S. MA [//]; Wunz, Timothy PhD **
48(10):923-933, October 2010.
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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 Fulltext 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.
(C) 2010 Lippincott Williams & Wilkins, Inc.