Mohammed Mohammed A, Moles Rebekah J, Chen Timothy F
The University of Sydney, Australia
The University of Sydney, Australia.
Ann Pharmacother. 2016 Oct;50(10):862-81. doi: 10.1177/1060028016656016. Epub 2016 Jun 29.
To evaluate the impact of pharmaceutical care (PC) interventions on health-related quality of life (HRQoL) and determine sensitivity of HRQoL measures to PC services.
MEDLINE, EMBASE, International Pharmaceutical Abstracts, PubMed, Global Health, PsychINFO, CINAHL, and Web of Science (January 2005 to September 2015) were searched.
Original English-language articles were included if PC impact on HRQoL was evaluated and reported using validated HRQoL measures.
A total of 31 randomized controlled trials, 9 nonrandomized studies with comparison groups, and 8 before-after studies were included. PC interventions resulted in significant improvement in 1 domain and ≥3 domains of HRQoL measures in 66.7% and 27.1% of the studies, respectively. There was a significant improvement in at least 1 domain in 18 of 32 studies using generic and 16 of 21 studies using disease-specific measures. When the Short Form 36 Items Health Survey (SF-36) measure was used, PC interventions had a moderate impact on social functioning (standardized mean difference [SMD] = 0.59; 95% CI = 0.14, 1.04), general health (SMD = 0.36; 95% CI = 0.12, 0.59), and physical functioning (SMD = 0.30; 95% CI = 0.11, 0.48). The pooled data on heart failure-specific (SMD = -0.17; 95% CI = -0.43, 0.09), asthma-specific (SMD = 0.17; 95% CI = -0.03, 0.36), and chronic obstructive pulmonary disease-specific (SMD = -0.09; 95% CI = -0.37, 0.19) measures indicated no significant impact of PC on HRQoL.
PC interventions can significantly improve at least 1 domain of HRQoL. Existing measures may have minimal to moderate sensitivity to PC interventions, with evidence pointing more toward social functioning, general health, and physical functioning of the SF-36 measure. However, evidence generated from current non-PC-specific HRQoL measures is insufficient to judge the impact of PC interventions on HRQoL. The development of a suitable HRQoL measure for PC interventions may help generate better evidence for the contribution of pharmacist services to improving HRQoL.
评估药学服务（PC）干预对健康相关生活质量（HRQoL）的影响，并确定HRQoL测量指标对PC服务的敏感性。
检索了MEDLINE、EMBASE、国际药学文摘、PubMed、全球健康、PsychINFO、CINAHL和科学网（2005年1月至2015年9月）。
如果使用经过验证的HRQoL测量指标评估并报告了PC对HRQoL的影响，则纳入原始英文文章。
共纳入31项随机对照试验、9项有对照组的非随机研究和8项前后对照研究。PC干预分别使66.7%和27.1%的研究中HRQoL测量指标的1个领域和≥3个领域有显著改善。在使用通用测量指标的32项研究中的18项以及使用疾病特异性测量指标的21项研究中的16项中，至少有1个领域有显著改善。当使用简短健康调查问卷（SF-36）测量指标时，PC干预对社会功能（标准化均数差[SMD]=0.59；95%置信区间[CI]=0.14，1.04）、总体健康（SMD=0.36；95%CI=0.12，0.59）和身体功能（SMD=0.30；95%CI=0.11，0.48）有中度影响。关于心力衰竭特异性（SMD=-0.17；95%CI=-0.43，0.09）、哮喘特异性（SMD=0.17；95%CI=-0.03，0.36）和慢性阻塞性肺疾病特异性（SMD=-0.09；95%CI=-0.37，0.19）测量指标的汇总数据表明，PC对HRQoL没有显著影响。
PC干预可显著改善HRQoL的至少1个领域。现有测量指标对PC干预的敏感性可能最低至中度，证据更多指向SF-36测量指标的社会功能、总体健康和身体功能。然而，目前非PC特异性HRQoL测量指标所产生的证据不足以判断PC干预对HRQoL的影响。开发适用于PC干预的HRQoL测量指标可能有助于为药师服务对改善HRQoL的贡献提供更好的证据。
