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临床药师参与医院查房的成本及成本效益的系统评价。

A systematic review of the costs and cost-effectiveness of clinical pharmacists on hospital ward rounds.

机构信息

Pharmacy Department, Royal Brisbane and Women's Hospital , Brisbane , Australia.

School of Pharmacy, University of Queensland , Brisbane , Australia.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2019 Oct;19(5):551-559. doi: 10.1080/14737167.2019.1643089. Epub 2019 Jul 15.

Abstract

: There is a lack of good quality economic evidence for the inclusion of pharmacists on hospital ward rounds in addition to, or as an alternative to, traditional ward-based clinical pharmacy services. There has been no systematic review of the cost or cost-effectiveness of pharmacists attending and contributing on ward rounds. : A literature search was conducted in Medline, Embase, Cochrane, and CINAHL and reported in accordance with the PRISMA guidelines in May 2019. As well, a search using Google Scholar and a targeted hand search were undertaken. Studies that reported any estimate of the cost or cost-effectiveness were included if pharmacist participation on inpatient hospital ward rounds was the predominant focus of the intervention. The identified studies were subsequently screened by three reviewers who extracted data on their clinical and economic design. A bias assessment was completed using the ROBINS-I tool. : Seven studies were identified investigating a clinical pharmacist's inclusion on hospital ward rounds where there was a cost estimated. However, none were deemed to be a full economic evaluation and all were found to be open to a serious risk of bias. Future evaluations should include a comparator group and investigate the cost and cost savings of the service, alongside their clinical outcomes.

摘要

除了传统的基于病房的临床药学服务外,在医院病房查房中增加药剂师,或者用药剂师替代传统的基于病房的临床药学服务,目前缺乏高质量的经济证据。尚未对药剂师参与和查房的成本或成本效益进行系统评价。

2019 年 5 月,我们按照 PRISMA 指南在 Medline、Embase、Cochrane 和 CINAHL 中进行了文献检索,并使用 Google Scholar 和有针对性的手工检索进行了补充。如果药师参与住院患者病房查房是干预的主要重点,则纳入报告任何成本或成本效益估计的研究。随后,由三名评审员对已确定的研究进行了筛选,他们提取了有关临床和经济设计的数据。使用 ROBINS-I 工具完成了偏倚评估。

确定了七项研究,调查了临床药师参与医院病房查房的情况,其中有成本估算。然而,没有一项被认为是完整的经济评估,所有研究都存在严重的偏倚风险。未来的评估应包括对照组,并调查该服务的成本和节省的成本,以及他们的临床结果。

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