School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Subang Jaya, Selangor, Malaysia.
Gerentology Laboratory, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Selangor, Malaysia.
Br J Clin Pharmacol. 2019 Dec;85(12):2668-2688. doi: 10.1111/bcp.14101. Epub 2019 Nov 3.
Pharmacists have been contributing to the care of residents in nursing homes and play a significant role in ensuring quality use of medicine. However, the changing role of pharmacist in nursing homes and their impact on residents is relatively unknown.
Six electronic databases were searched from inception until November 2018 for articles published in English examining the services offered by pharmacists in nursing homes. Studies were included if it examined the impact of interventions by pharmacists to improve the quality use of medicine in nursing homes.
Fifty-two studies (30 376 residents) were included in the current review. Thirteen studies were randomised controlled studies, while the remainder were either pre-post, retrospective or case-control studies where pharmacists provided services such as clinical medication review in collaboration with other healthcare professionals as well as staff education. Pooled analysis found that pharmacist-led services reduced the mean number of falls (-0.50; 95% confidence interval: -0.79 to -0.21) among residents in nursing homes. Mixed results were noted on the impact of pharmacists' services on mortality, hospitalisation and admission rates among residents. The potential financial savings of such services have not been formally evaluated by any studies thus far. The strength of evidence was moderate for the outcomes of mortality and number of fallers.
Pharmacists contribute substantially to patient care in nursing homes, ensuring quality use of medication, resulting in reduced fall rates. Further studies with rigorous design are needed to measure the impact of pharmacist services on the economic benefits and other patient health outcomes.
药剂师一直在为养老院的居民提供护理，并在确保合理用药方面发挥着重要作用。然而，药剂师在养老院中的角色变化及其对居民的影响尚不清楚。
从建库至 2018 年 11 月，我们检索了 6 个电子数据库，以查找发表的评估药剂师在养老院提供服务的英文文章。如果研究考察了药剂师干预措施对改善养老院合理用药的影响，则将其纳入研究。
当前综述共纳入 52 项研究（30376 名居民）。13 项研究为随机对照研究，其余研究为前后对照、回顾性或病例对照研究，其中药剂师与其他医护人员合作提供临床药物评估服务，并对工作人员进行教育。汇总分析发现，药剂师主导的服务可降低养老院居民的跌倒发生率（-0.50；95%置信区间：-0.79 至-0.21）。但药剂师服务对居民死亡率、住院率和入院率的影响结果不一。迄今为止，尚无研究正式评估此类服务的潜在节省费用。关于死亡率和跌倒人数的结局，证据强度为中等。
药剂师在养老院的患者护理中做出了重大贡献，确保了药物的合理使用，从而降低了跌倒率。需要进一步进行设计严谨的研究，以衡量药剂师服务对经济效益和其他患者健康结局的影响。
