Zhong Han, Ni Xiao-Jun, Cui Min, Liu Xiao-Yan
Department of Pharmacy, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
Int J Clin Pharm. 2014 Dec;36(6):1230-40. doi: 10.1007/s11096-014-0024-9. Epub 2014 Oct 22.
In chronic obstructive pulmonary disease (COPD), the value of pharmacist care is not clear. Aim of the review A systematic review was conducted to clarify the impact of pharmacist care for outpatients with COPD.
The PubMed, EMBASE, CINAHL, CBMdisc, and Cochrane Central Register of Controlled Trials databases were searched for randomized controlled trials that involved pharmacist-care interventions among outpatients with COPD. The reference lists were also screened for any additional relevant studies not identified through the electronic database searching. Two reviewers independently assessed each paper for methodological quality and extracted the data.
Fourteen articles were included. These articles described eight randomized controlled trials (1,327 patients) that pharmacist care was compared with usual care. The pharmacist interventions included those exclusively conducted by pharmacists and those conducted in collaboration with a multidisciplinary team. Although the current evidences failed to illustrate significant improvement in the health-related quality of life in intervention patients, results indicated that pharmacist care was associated with a significant reduction in the risk of hospital admissions [six studies (684 patients); risk ratio 0.50 (95% CI 0.39-0.64)]. However, no significant effect was found either in emergency department visits or in lung function. In addition, pharmacist care improved medication compliance of patients [four studies (743 patients); risk ratio 1.23 (95% CI 1.11-1.36)] while reduced health-related cost [three studies (318 patients); standardized mean difference -0.37 (95% CI -0.59 to -0.15)].
Pharmacist care resulted in improvements in the medication compliance as well as reductions in hospital admissions and health-related costs. It is therefore a potent strategy for management of outpatients with COPD.
在慢性阻塞性肺疾病（COPD）中，药师护理的价值尚不清楚。综述目的：进行一项系统综述，以阐明药师护理对COPD门诊患者的影响。
检索了PubMed、EMBASE、CINAHL、CBMdisc和Cochrane对照试验中央注册库数据库，查找涉及COPD门诊患者药师护理干预的随机对照试验。还对参考文献列表进行了筛选，以查找通过电子数据库检索未识别出的任何其他相关研究。两名评审员独立评估每篇论文的方法学质量并提取数据。
纳入了14篇文章。这些文章描述了8项随机对照试验（1327例患者），将药师护理与常规护理进行了比较。药师干预包括仅由药师进行的干预以及与多学科团队合作进行的干预。尽管目前的证据未能说明干预患者的健康相关生活质量有显著改善，但结果表明药师护理与住院风险的显著降低相关[6项研究（684例患者）；风险比0.50（95%CI 0.39 - 0.64）]。然而，在急诊就诊或肺功能方面未发现显著影响。此外，药师护理提高了患者的用药依从性[4项研究（743例患者）；风险比1.23（95%CI 1.11 - 1.36）]，同时降低了健康相关成本[3项研究（318例患者）；标准化均值差 -0.37（95%CI -0.59至 -0.15）]。
药师护理提高了用药依从性，同时降低了住院率和健康相关成本。因此，它是管理COPD门诊患者的有效策略。
