J Am Pharm Assoc (2003). 2019 Nov-Dec;59(6):787-791.e1. doi: 10.1016/j.japh.2019.06.015. Epub 2019 Jul 13.
Pharmacists play an important role in supporting the health care needs of the public, and various studies have examined the impact of pharmacy services on patient care. This systematic review aimed to describe studies evaluating the impact of pharmacy services by means of network meta-analyses.
A systematic literature review of network meta-analyses examining pharmacy services was performed on PubMed, Embase, International Pharmaceutical Abstracts, and Cochrane Database of Systematic Reviews from database inception to November 30, 2018.
Network meta-analyses that examined the comparative effectiveness of pharmacy services (where pharmacists provide patient care to optimize patient outcomes) in any population, country, or setting.
Data were independently extracted by 2 authors with the use of a standardized extraction form. The methodologic quality of articles was assessed with the use of the Cochrane Risk of Bias in Systematic Reviews tool.
Two network meta-analysis studies were identified. The first study compared 53 randomized controlled trials evaluating the effectiveness of transitional care services among discharged patients with heart failure. The study found that pharmacist interventions such as medication reconciliation, patient education, and medication optimization had little impact on improving the all-cause mortality and readmission rate in these patients. The second report compared 43 randomized controlled trials examining the efficacy of pharmacist-based diabetes educational interventions with or without pharmaceutical care on people with type 2 diabetes. It was reported that pharmacy services were effective in reducing glycosylated hemoglobin among people with type 2 diabetes, with larger effect sizes observed when these services involved a combination of 2 or more pharmacy services.
This study demonstrated a paucity of studies using network meta-analysis techniques in evaluating pharmacist-provided services. This could be due to the lack of confidence in using this method, because network meta-analysis requires several additional assumptions that require careful consideration while performing the analysis.
药剂师在满足公众的医疗保健需求方面发挥着重要作用，许多研究都考察了药房服务对患者护理的影响。本系统评价旨在描述通过网络荟萃分析评估药房服务效果的研究。
从数据库建立到 2018 年 11 月 30 日，在 PubMed、Embase、国际药学文摘和 Cochrane 系统评价数据库中，对考察药房服务的网络荟萃分析进行了系统文献检索。
考察任何人群、国家或环境下，药剂师提供患者护理以优化患者结局的药房服务的比较有效性的网络荟萃分析。
两名作者独立使用标准化提取表提取数据。使用 Cochrane 系统评价偏倚风险工具评估文章的方法学质量。
确定了两项网络荟萃分析研究。第一项研究比较了 53 项评估心力衰竭出院患者过渡护理服务效果的随机对照试验。研究发现，药师干预措施，如药物重整、患者教育和药物优化，对改善这些患者的全因死亡率和再入院率几乎没有影响。第二项报告比较了 43 项考察基于药师的糖尿病教育干预措施与或不与药物治疗相结合对 2 型糖尿病患者疗效的随机对照试验。结果表明，药房服务在降低 2 型糖尿病患者的糖化血红蛋白方面是有效的，当这些服务结合了 2 种或更多种药房服务时，效果更为显著。
本研究表明，使用网络荟萃分析技术评估药剂师提供的服务的研究很少。这可能是由于对使用这种方法缺乏信心，因为网络荟萃分析需要额外的假设，在进行分析时需要仔细考虑。
