US pharmacists' effect as team members on patient care: systematic review and meta-analyses.

Abstract:

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.

journal_name

Med Care

journal_title

Medical care

authors

Chisholm-Burns MA,Kim Lee J,Spivey CA,Slack M,Herrier RN,Hall-Lipsy E,Graff Zivin J,Abraham I,Palmer J,Martin JR,Kramer SS,Wunz T

doi

10.1097/MLR.0b013e3181e57962

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

923-33

issue

10

eissn

0025-7079

issn

1537-1948

journal_volume

48

pub_type

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