Prasad Sharmila S, Duncanson Kerith, Keely Simon, Talley Nicholas J, Kairuz Therése, Holtmann Gerald J, Shah Ayesha, Walker Marjorie M
Faculty of Health and Medicine, School of Biomedical Science and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia.
Priority Research Centre, Digestive Health and Neurogastroenterology, University of Newcastle, New Lambton Heights, NSW 2305, Australia.
Pharmacy (Basel). 2020 Nov 2;8(4):204. doi: 10.3390/pharmacy8040204.
Chronic disease, particularly inflammatory bowel disease (IBD), requires a multifaceted approach to managing patients, but it is apparent that primary care pharmacists are being underutilized. To demonstrate the benefits of pharmacist interventions in primary care, a systematic review was conducted of interventions in asthma and type 2 diabetes where pharmacists have a defined role in chronic disease management. We also explored potential opportunities for primary care pharmacists to deliver tailored care to patients with inflammatory bowel disease. The search strategy retrieved original research articles from seven databases; eligible articles were assessed for inclusion. Quality appraisal was performed independently by two reviewers. Thirty-seven included studies were grouped into four categories of interventions: education/counseling (43%), medication management (34%), monitoring/follow-up (17%), and screening/risk prevention (6%). Education plus counseling was reported as the main intervention delivered by pharmacists. Three measurable outcomes were identified: clinical, humanistic (e.g., quality of life), and economic. Clinical outcomes (63%) were reported more commonly than humanistic (26%) and economic (11%) outcomes. Pharmacist interventions led to statistically significant improvements in control of disease, severity, and medication adherence, as well as improvements in overall patient satisfaction, quality of life among patients with asthma and type 2 diabetes. As one of the most accessible sources of primary health care, pharmacists are well-placed to minimize the impact of chronic diseases on patients and communities. Evidence suggests there are opportunities for primary care pharmacists to play a more active role in the management of chronic diseases such as IBD.
慢性病，尤其是炎症性肠病（IBD），需要采取多方面的方法来管理患者，但很明显，基层医疗药师的作用未得到充分发挥。为了证明药师干预在基层医疗中的益处，我们对药师在哮喘和2型糖尿病慢性病管理中发挥明确作用的干预措施进行了系统综述。我们还探索了基层医疗药师为炎症性肠病患者提供个性化护理的潜在机会。检索策略从七个数据库中检索了原始研究文章；对符合条件的文章进行了纳入评估。由两名评审员独立进行质量评估。纳入的37项研究分为四类干预措施：教育/咨询（43%）、药物管理（34%）、监测/随访（17%）和筛查/风险预防（6%）。据报告，教育加咨询是药师提供的主要干预措施。确定了三个可衡量的结果：临床、人文（如生活质量）和经济。临床结果（63%）的报告比人文结果（26%）和经济结果（11%）更常见。药师干预在疾病控制、严重程度和药物依从性方面带来了统计学上的显著改善，同时也提高了总体患者满意度、哮喘和2型糖尿病患者的生活质量。作为基层医疗最易获取的资源之一，药师处于有利地位，可将慢性病对患者和社区的影响降至最低。有证据表明，基层医疗药师有机会在炎症性肠病等慢性病的管理中发挥更积极的作用。
