Dalton Kieran, Byrne Stephen
Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
Integr Pharm Res Pract. 2017 Jan 25;6:37-46. doi: 10.2147/IPRP.S108047. eCollection 2017.
Global healthcare expenditure is escalating at an unsustainable rate. Money spent on medicines and managing medication-related problems continues to grow. The high prevalence of medication errors and inappropriate prescribing is a major issue within healthcare systems, and can often contribute to adverse drug events, many of which are preventable. As a result, there is a huge opportunity for pharmacists to have a significant impact on reducing healthcare costs, as they have the expertise to detect, resolve, and prevent medication errors and medication-related problems. The development of clinical pharmacy practice in recent decades has resulted in an increased number of pharmacists working in clinically advanced roles worldwide. Pharmacist-provided services and clinical interventions have been shown to reduce the risk of potential adverse drug events and improve patient outcomes, and the majority of published studies show that these pharmacist activities are cost-effective or have a good cost:benefit ratio. This review demonstrates that pharmacists can contribute to substantial healthcare savings across a variety of settings. However, there is a paucity of evidence in the literature highlighting the specific aspects of pharmacists' work which are the most effective and cost-effective. Future high-quality economic evaluations with robust methodologies and study design are required to investigate what pharmacist services have significant clinical benefits to patients and substantiate the greatest cost savings for healthcare budgets.
全球医疗保健支出正以不可持续的速度增长。用于药品和处理与药物相关问题的费用持续攀升。用药错误和不适当处方的高发生率是医疗保健系统中的一个主要问题,并且常常会导致药物不良事件,其中许多是可以预防的。因此,药剂师有巨大的机会对降低医疗保健成本产生重大影响,因为他们具备发现、解决和预防用药错误及与药物相关问题的专业知识。近几十年来临床药学实践的发展导致全球范围内担任临床高级职位的药剂师数量增加。药剂师提供的服务和临床干预已被证明可降低潜在药物不良事件的风险并改善患者预后,并且大多数已发表的研究表明这些药剂师的活动具有成本效益或具有良好的成本效益比。本综述表明,药剂师可以在各种环境中为大幅节省医疗保健费用做出贡献。然而,文献中缺乏证据突出药剂师工作中最有效和最具成本效益的具体方面。需要未来采用稳健方法和研究设计的高质量经济评估来调查哪些药剂师服务对患者具有显著的临床益处,并为医疗保健预算证实最大的成本节省。