Kjeldsen Lene Juel, Olesen Charlotte, Hansen Merete Kjær, Nielsen Trine Rune Høgh
The Danish Research Unit for Hospital Pharmacy, Amgros I/S, 2100 Copenhagen, Denmark.
The Hospital Pharmacy, Central Denmark Region, 8000 Aarhus, Denmark.
Pharmacy (Basel). 2017 May 20;5(2):28. doi: 10.3390/pharmacy5020028.
The objective was to investigate type, frequency and result of clinical outcomes used in studies to assess the effect of clinical pharmacy interventions in inpatient care. The literature search using Pubmed.gov was performed for the period up to 2013 using the search phrases: "Intervention(s)" and "pharmacist(s)" and "controlled" and "outcome(s)" or "effect(s)". Primary research studies in English of controlled, clinical pharmacy intervention studies, including outcome evaluation, were selected. Titles, abstracts and full-text papers were assessed individually by two reviewers, and inclusion was determined by consensus. In total, 37 publications were included in the review. The publications presented similar intervention elements but differed in study design. A large variety of outcome measures (135) had been used to evaluate the effect of the interventions; most frequently clinical measures/assessments by physician and health care service use. No apparent pattern was established among primary outcome measures with significant effect in favour of the intervention, but positive effect was most frequently related to studies that included power calculations and sufficient inclusion of patients (73% vs. 25%). This review emphasizes the importance of considering the relevance of outcomes selected to assess clinical pharmacy interventions and the importance of conducting a proper power calculation.
目的是调查用于评估临床药学干预对住院患者护理效果的研究中所采用的临床结局的类型、频率和结果。利用搜索词“干预措施”、“药剂师”、“对照”、“结局”或“效果”,通过Pubmed.gov对截至2013年的文献进行检索。选取了英文的对照临床药学干预研究的初级研究,包括结局评估。两名评审员分别对标题、摘要和全文进行评估,并通过协商确定纳入标准。该综述共纳入37篇出版物。这些出版物呈现出相似的干预要素,但研究设计有所不同。大量的结局指标(135个)被用于评估干预效果;最常用的是医生的临床指标/评估以及医疗服务利用情况。在对干预有显著效果的主要结局指标中未发现明显模式,但积极效果最常与包含功效计算且纳入足够患者的研究相关(73%对25%)。本综述强调了考虑所选结局指标对评估临床药学干预的相关性的重要性以及进行适当功效计算的重要性。