Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Finland.
Hyvinkää 3rd Pharmacy, Hyvinkää, Finland.
J Am Geriatr Soc. 2018 Aug;66(8):1613-1620. doi: 10.1111/jgs.15416. Epub 2018 Jul 4.
To identify medication review interventions for older adults that involve community pharmacists and evidence of outcomes of these interventions.
Systematic review.
Cinahl, MEDLINE (Ovid), Scopus, International Pharmaceutical Abstracts, and Cochrane Library were searched for articles published between January 2000 and February 2016. Articles involving community pharmacists in medication reviews for outpatients aged 65 and older were included. Evidence of economic, clinical, and humanistic outcomes of interventions was summarized.
Sixteen articles were found that described 12 medication review interventions, of which 6 were compliance and concordance reviews, 4 were clinical medication reviews, and 2 were prescription reviews according to a previously developed typology. Community pharmacists' contributions to reviewing medications varied from sending the dispensing history to other healthcare providers to comprehensive involvement in medication management. The most commonly assessed outcomes of the interventions were medication changes leading to reduction in actual or potential drug-related problems (n=12) and improved adherence (n=5).
Regardless of community pharmacists' contributions to interventions, medication review interventions seem to reduce drug-related problems and increase medication adherence. More well-designed, rigorous studies with more sensitive and specific outcomes measures need to be conducted to assess the effect of community pharmacists' contributions to reviewing medications and improving the health of older adults.
确定涉及社区药剂师的老年人药物审查干预措施,并提供这些干预措施结果的证据。
系统评价。
在 2000 年 1 月至 2016 年 2 月期间,检索了 Cinahl、MEDLINE(Ovid)、Scopus、国际药学文摘和 Cochrane 图书馆中的文章。纳入了涉及社区药剂师对 65 岁及以上门诊患者进行药物审查的文章。总结了干预措施的经济、临床和人文结果的证据。
共发现 16 篇文章描述了 12 项药物审查干预措施,其中 6 项是依从性和一致性审查,4 项是临床药物审查,根据先前制定的分类法,2 项是处方审查。社区药剂师在审查药物方面的贡献从将配药历史发送给其他医疗保健提供者到全面参与药物管理不等。干预措施最常评估的结果是药物改变导致实际或潜在药物相关问题减少(n=12)和依从性提高(n=5)。
无论社区药剂师对干预措施的贡献如何,药物审查干预措施似乎都能减少药物相关问题并提高药物依从性。需要进行更多设计良好、严格的研究,使用更敏感和具体的结果测量方法,以评估社区药剂师对药物审查和改善老年人健康的贡献的效果。