Wang Y, Yeo Q Q, Ko Y
Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
Diabet Med. 2016 Apr;33(4):421-7. doi: 10.1111/dme.12976. Epub 2015 Oct 28.
To review and evaluate the most recent literature on the economic outcomes of pharmacist-managed services in people with diabetes.
The global prevalence of diabetes is increasing. Although pharmacist-managed services have been shown to improve people's health outcomes, the economic impact of these programmes remains unclear.
A systematic review was conducted of six databases. Study inclusion criteria were: (1) original research; (2) evaluation of pharmacist-managed services in people with diabetes; (3) an economic evaluation; (4) English-language publication; and (5) full-text, published between January 2006 and December 2014. The quality of the full economic evaluations reviewed was evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist.
A total of 2204 articles were screened and 25 studies were selected. These studies were conducted in a community pharmacy (n = 10), a clinic- /hospital-based outpatient facility (n = 8), or others. Pharmacist-managed services included targeted education (n = 24), general pharmacotherapeutic monitoring (n = 21), health screening or laboratory testing services (n = 9), immunization services (n = 2) and pharmacokinetic monitoring (n = 1). Compared with usual care, pharmacist-managed services resulted in cost savings that varied from $7 to $65,000 ($8 to $85,000 in 2014 US dollars) per person per year, and generated higher quality-adjusted life years with lower costs. Benefit-to-cost ratios ranged from 1:1 to 8.5:1. Among the 25 studies reviewed, 11 were full economic evaluations of moderate quality.
Pharmacist-managed services had a positive return in terms of economic viability. With the expanding role of pharmacists in the healthcare sector, alongside increasing health expenditure, future economic studies of high quality are needed to investigate the cost-effectiveness of these services.
回顾并评估关于药剂师管理服务对糖尿病患者经济影响的最新文献。
全球糖尿病患病率正在上升。尽管药剂师管理服务已被证明可改善人们的健康状况，但这些项目的经济影响仍不明确。
对六个数据库进行了系统综述。研究纳入标准为：（1）原创研究；（2）对糖尿病患者药剂师管理服务的评估；（3）经济评估；（4）英文出版物；（5）全文，发表于2006年1月至2014年12月之间。使用《综合卫生经济评估报告标准》清单对所审查的全面经济评估的质量进行评估。
共筛选出2204篇文章，选取了25项研究。这些研究在社区药房（n = 10）、基于诊所/医院的门诊设施（n = 8）或其他场所进行。药剂师管理服务包括针对性教育（n = 24）、一般药物治疗监测（n = 21）、健康筛查或实验室检测服务（n = 9）、免疫接种服务（n = 2）和药代动力学监测（n = 1）。与常规护理相比，药剂师管理服务每年可为每人节省7美元至65,000美元（2014年美元为8美元至85,000美元）的成本，并以更低的成本产生更高的质量调整生命年。效益成本比范围为1:1至8.5:1。在所审查的25项研究中，11项为中等质量的全面经济评估。
就经济可行性而言，药剂师管理服务有积极回报。随着药剂师在医疗保健领域的作用不断扩大，以及卫生支出的增加，需要开展未来高质量的经济研究来调查这些服务的成本效益。
