Quality Use of Medicines & Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
Health Strategy and Policy Institute, Ministry of Health of Vietnam.
J Alzheimers Dis. 2019;71(1):83-96. doi: 10.3233/JAD-190162.
Medication use in people with dementia and/or cognitive impairment (PWD/CI) is challenging. As medication experts, pharmacists have an important role in improving care of this vulnerable population.
Systematically review evidence for the effectiveness of pharmacist-led interventions on quality use of medicines, quality of life, and health outcomes of PWD/CI.
A systematic review was conducted using MEDLINE, EMBASE, PsycINFO, Allied and Complementary Medicine (AMED) and Cumulative index to Nursing and Allied Health Literature (CINAHL) databases from conception to 20 March 2017. Full articles published in English were included. Data were synthesized using a narrative approach.
Nine studies were eligible for inclusion. All studies were from high-income countries and assessed pharmacist-led medication management services. There was great variability in the content and focus of services described and outcomes reported. Pharmacists were found to provide a number of cognitive services including medication reconciliation, medication review, and medication adherence services. These services were generally effective with regards to improving quality use of medicines and health outcomes for PWD/CI and their caregivers, and for saving costs to the healthcare system. Pharmacist-led medication and dementia consultation services may also improve caregiver understanding of dementia and the different aspects of pharmacotherapy, thus improving medication adherence.
Emerging evidence suggests that pharmacist-led medication management services for PWD/CI may improve outcomes. Future research should confirm these findings using more robust study designs and explore additional roles that pharmacists could undertake in the pursuit of supporting PWD/CI.
痴呆症和/或认知障碍患者（PWD/CI）的药物治疗具有挑战性。作为药物治疗专家，药剂师在改善这一弱势群体的护理方面发挥着重要作用。
系统回顾药剂师主导的干预措施对改善 PWD/CI 人群药物使用质量、生活质量和健康结果的有效性证据。
从概念到 2017 年 3 月 20 日，使用 MEDLINE、EMBASE、PsycINFO、联合和补充医学（AMED）和护理与联合健康文献累积索引（CINAHL）数据库进行了系统回顾。纳入发表在英文期刊上的全文文章。使用叙述方法综合数据。
符合纳入标准的研究有 9 项。所有研究均来自高收入国家，评估了药剂师主导的药物管理服务。所描述的服务内容和重点以及报告的结果存在很大差异。药剂师提供了许多认知服务，包括药物重整、药物审查和药物依从性服务。这些服务在改善 PWD/CI 及其护理人员的药物使用质量和健康结果以及节省医疗保健系统成本方面通常是有效的。药剂师主导的药物和痴呆症咨询服务还可以提高护理人员对痴呆症和药物治疗各个方面的理解，从而提高药物依从性。
新兴证据表明，药剂师主导的 PWD/CI 药物管理服务可能改善结局。未来的研究应使用更强大的研究设计来证实这些发现，并探索药剂师在支持 PWD/CI 方面可以承担的其他角色。
