Department of Pharmacy Practice and Administrative Sciences, Pharmacoeconomics, Epidemiology, and Pharmaceutical Policy and Outcomes Research, College of Pharmacy, University of New Mexico, MSC 09 5360, 2502 Marble Avenue, NE, Albuquerque, NM 87131, USA.
Res Social Adm Pharm. 2013 May-Jun;9(3):311-29. doi: 10.1016/j.sapharm.2012.05.004. Epub 2012 Jul 25.
The U.S. population of racial/ethnic minorities continues to increase; however, health disparities and poor health outcomes among many of them continue to be a major public health problem confronting the U.S. health care system.
The objective of this review was to summarize published pharmaceutical care services literature reporting economic, clinical, and/or humanistic outcomes (ECHOs) among racial/ethnic minorities. Studies that reported differences by race/ethnicity and studies where most participants were from multiracial/ethnic minorities were included.
PubMed and International Pharmaceutical Abstracts databases were searched for articles that reported the effects of pharmaceutical care on ECHOs among racial/ethnic minorities published between January 1980 and November 2010. The literature review was focused on racial groups that included black/African-American, Native American, Indian American Asian, Alaska Native, Native Hawaiian, and Pacific Islander patients, and ethnic group that was non-white Hispanic/Latino patients.
There were 24 articles that studied the impact of pharmaceutical care on ECHOs by race/ethnicity or where most participants were from multiracial/ethnic minorities. Twenty-three studies reported that pharmaceutical care has a positive impact on health outcomes of the studied populations. About half of the studies meeting inclusion criteria evaluated only 1 type of patient outcome, primarily clinical outcomes. Education/consultation and medication/therapy management were the most commonly evaluated types of pharmaceutical care services throughout the studied groups. Comprehensive disease management was evaluated mainly in multiracial/ethnic populations and blacks/African-Americans. Few studies adopted randomized controlled designs, which make it difficult to attribute changes in patient outcomes to the provision of pharmaceutical care. Nine studies that involved cooperation between pharmacists and other medical professionals reflect an increased tendency for interprofessional collaboration in the current health care system.
This review shows that there is a positive relationship between pharmaceutical care and ECHOs in patients from racial/ethnic minority groups. However, more studies are needed to document the effects of pharmaceutical care on reducing racial/ethnic health disparities and to determine which interventions are most effective among certain groups with health disparities.
美国的种族/少数民族人口持续增加；然而，其中许多人的健康差距和较差的健康结果仍然是美国医疗保健系统面临的主要公共卫生问题。
本综述的目的是总结已发表的药学保健服务文献，报告少数族裔人群的经济、临床和/或人文结果（ECHO）。包括报告种族差异的研究和大多数参与者来自多种族/少数民族的研究。
检索了 1980 年 1 月至 2010 年 11 月期间发表的关于药学保健对少数族裔人群 ECHO 影响的文章，这些文章发表在 PubMed 和国际药学摘要数据库中。文献综述主要集中在包括黑/African-American、美国原住民、印度裔美国人、亚洲人、阿拉斯加原住民、夏威夷原住民和太平洋岛民患者的种族群体以及非白西班牙裔/拉丁裔患者的种族群体。
有 24 篇文章研究了药学保健对 ECHO 或大多数参与者来自多种族/少数民族的种族/民族的影响。23 项研究报告称，药学保健对所研究人群的健康结果有积极影响。符合纳入标准的研究中约有一半仅评估了 1 种患者结果，主要是临床结果。在整个研究人群中，教育/咨询和药物/治疗管理是最常评估的药学保健服务类型。综合疾病管理主要在多种族/少数民族人群和黑人/African-American 中进行评估。很少有研究采用随机对照设计，这使得难以将患者结果的变化归因于药学保健的提供。有 9 项涉及药剂师与其他医疗专业人员合作的研究反映了当前医疗保健系统中跨专业合作的趋势增加。
本综述表明，药学保健与少数族裔人群的 ECHO 之间存在积极关系。然而，需要更多的研究来记录药学保健在减少种族/民族健康差距方面的效果，并确定在具有健康差距的某些群体中哪些干预措施最有效。
