Cohen Victor, Jellinek Samantha P, Hatch Amie, Motov Sergey
Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Brooklyn, NY 11219, USA.
Am J Health Syst Pharm. 2009 Aug 1;66(15):1353-61. doi: 10.2146/ajhp080304.
A systematic literature review was conducted to ascertain the scope of involvement of clinical pharmacists in the emergency department (ED); summarize economic, humanistic, and clinical outcomes data; describe current limitations of these data; and identify areas for future research.
A search of MEDLINE, The Cochrane Library, International Pharmaceutical Abstracts, and CINAHL Plus databases was conducted. Articles were included in this review if the title and abstract indicated that the article's content addressed the scope of involvement of pharmacists in the ED or pharmacist interventions in the ED and their associated outcomes, such as humanistic outcomes, cost avoidance, or improved quality. Qualitative analyses were conducted to characterize pharmacists' activities and effects in the ED.
Of the 533 returned citations, only 17 met the inclusion criteria. Each provided a description of clinical pharmacy services at 12 different institutions. Descriptions of these institutions and job responsibilities of the ED pharmacists are described. Six studies reported information about pharmacist interventions, including the number and types of interventions, time spent per intervention, and acceptance rate of interventions. Four studies reported cost-related outcomes data.
A review of the literature revealed that pharmacists have been involved in the ED for decades. Services provided by pharmacists in the ED included traditional clinical pharmacy services, responding to medical emergencies, providing consultations on medication issues, identifying and reducing medication errors, and conducting medication histories at hospital admission. Some services were shown to be cost saving or cost avoiding.
进行一项系统的文献综述，以确定临床药师在急诊科的参与范围；总结经济、人文和临床结局数据；描述这些数据目前的局限性；并确定未来的研究领域。
对MEDLINE、Cochrane图书馆、国际药学文摘和CINAHL Plus数据库进行检索。如果文章的标题和摘要表明其内容涉及药师在急诊科的参与范围或药师在急诊科的干预措施及其相关结局，如人文结局、成本避免或质量改善，则将这些文章纳入本综述。进行定性分析以描述药师在急诊科的活动和影响。
在检索到的533篇文献中，只有17篇符合纳入标准。每篇文献都描述了12个不同机构的临床药学服务。介绍了这些机构以及急诊科药师的工作职责。六项研究报告了有关药师干预的信息，包括干预的数量和类型、每次干预花费的时间以及干预的接受率。四项研究报告了与成本相关的结局数据。
文献综述显示，药师参与急诊科工作已有数十年。药师在急诊科提供的服务包括传统的临床药学服务、应对医疗紧急情况、提供用药问题咨询、识别和减少用药错误以及在患者入院时进行用药史询问。一些服务显示出具有节省成本或避免成本的作用。
