Gatwood Justin, Gatwood Katie, Gabre Ezra, Alexander Maurice
University of Tennessee College of Pharmacy, Nashville, TN.
Vanderbilt University Medical Center, Nashville, TN.
Am J Health Syst Pharm. 2017 Oct 1;74(19):1549-1557. doi: 10.2146/ajhp160475.
Published literature describing the effectiveness of outpatient oncology services delivered by clinical pharmacists is summarized.
Peer-reviewed articles on studies evaluating the provision of outpatient oncology services by licensed clinical pharmacists in the United States were identified and screened according to a study-specific protocol. Only research publications focused on the care of oncology patients and indicating the evaluation of measurable services and outcomes were selected for review. Data from eligible studies were extracted using a standardized tool, and agreement by a majority of the investigators was required for inclusion of articles in the final review.
Eight publications were included in the review; nearly all were published since 2010. All of the included articles reported on results of observational studies in which data sourced from surveys, existing medical or prescription records, or medical cost information were analyzed to measure patient or provider satisfaction (or both) or patient-reported health outcomes. The evaluated evidence indicated that pharmacists were effective in identifying treatment issues and medication misuse, delivering satisfactory and valued services, and finding mechanisms to reduce medical costs or generate revenue to justify continuation or support expansion of clinical pharmacy services. Moreover, in two instances, pharmacists' services were associated with improvements in symptoms reported by oncology patients.
Available evidence suggests that outpatient oncology practices may benefit from integrating pharmacists into care models in order to more effectively, efficiently, and holistically address the needs of patients with cancer.
总结已发表的关于临床药师提供门诊肿瘤学服务有效性的文献。
根据特定研究方案,识别并筛选美国关于执业临床药师提供门诊肿瘤学服务评估的同行评审文章。仅选择专注于肿瘤患者护理且表明对可衡量服务和结果进行评估的研究出版物进行综述。使用标准化工具提取符合条件研究的数据,且纳入最终综述的文章需多数研究者达成一致。
八篇出版物被纳入综述;几乎所有文章自2010年以来发表。所有纳入文章均报告了观察性研究结果,其中分析了来自调查、现有医疗或处方记录或医疗成本信息的数据,以衡量患者或提供者满意度(或两者)或患者报告的健康结果。评估证据表明,药师在识别治疗问题和药物滥用、提供令人满意且有价值的服务以及找到降低医疗成本或创收的机制以证明临床药学服务的延续或支持其扩展方面是有效的。此外,在两个案例中,药师的服务与肿瘤患者报告的症状改善相关。
现有证据表明,门诊肿瘤学实践可能受益于将药师纳入护理模式,以便更有效、高效和全面地满足癌症患者的需求。