Rady Faculty of Health Sciences, University of Manitoba College of Pharmacy, Winnipeg, Canada.
Department of Pharmacy Practice, Sarada Vilas College of Pharmacy, Mysuru, India.
Epidemiol Health. 2019;41:e2019020. doi: 10.4178/epih.e2019020. Epub 2019 May 17.
To address and elucidate the impact of pharmacist-led home medicines review (HMR) services on identifying drug-related problems (DRPs) among the elderly population in home care settings.
A comprehensive systematic search was performed using electronic scientific databases such as PubMed, Scopus, Embase, and Web of Science for studies published between January 1, 2008 and December 31, 2018, pertaining to HMR services by pharmacists for identifying DRPs.
In total, 4,292 studies were retrieved from the searches, of which 24 were excluded as duplicates. Titles and abstracts were screened for the remaining 4,268 studies, of which 4,239 were excluded due to the extraneous nature of the titles and/or abstracts. Subsequently, 29 full-text articles were assessed, and 19 were removed for lacking the outcome of interest and/or not satisfying the study's inclusion criteria. Finally, 10 studies were included in the review; however, publication bias was not assessed, which is a limitation of this study. In all studies, pharmacists identified a highly significant amount of DRPs through HMR services. The most common types of DRPs were potential drug-drug interactions, serious adverse drug reactions, need for an additional drug, inappropriate medication use, non-adherence, untreated indications, excessive doses, and usage of expired medications.
HMR is a novel extended role played by pharmacists. The efficiency of such programs in identifying and resolving DRPs could minimize patients' health-related costs and burden, thereby enhancing the quality of life and well-being among the elderly.
探讨并阐明药剂师主导的家庭用药回顾（HMR）服务对识别居家养老环境中老年人药物相关问题（DRP）的影响。
通过电子科学数据库（如 PubMed、Scopus、Embase 和 Web of Science）对 2008 年 1 月 1 日至 2018 年 12 月 31 日期间发表的有关药剂师进行 HMR 服务以识别 DRP 的研究进行全面系统检索。
共从检索中获得 4292 项研究，其中 24 项因重复而被排除。对其余 4268 项研究的标题和摘要进行了筛选，其中 4239 项因标题和/或摘要的无关性而被排除。随后，评估了 29 篇全文文章，其中 19 篇因缺乏感兴趣的结果和/或不符合研究纳入标准而被排除。最后，共有 10 项研究纳入综述；然而，本研究存在未评估发表偏倚的局限性。在所有研究中，药剂师通过 HMR 服务发现了大量的 DRP。最常见的 DRP 类型是潜在的药物-药物相互作用、严重的药物不良反应、需要额外的药物、药物使用不当、不遵医嘱、未治疗的指征、剂量过大以及使用过期药物。
HMR 是药剂师发挥的一种新颖的扩展作用。此类项目在识别和解决 DRP 方面的效率可以最大限度地降低患者的健康相关成本和负担，从而提高老年人的生活质量和幸福感。
