影响药师在自身免疫性疾病管理中的作用：一项随机对照试验和非随机研究的系统评价。
Impact of pharmacist care in the management of autoimmune disorders: A systematic review of randomized control trials and non-randomized studies.
机构信息
Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, SS Nagar, Mysuru, 570015, Karnataka, India.
Department of Rheumatology & Immunology, JSS Medical College & Hospital, JSS Academy of Higher Education and Research, SS Nagar, Mysuru, 570015, Karnataka, India.
出版信息
Res Social Adm Pharm. 2021 Sep;17(9):1532-1545. doi: 10.1016/j.sapharm.2020.12.005. Epub 2020 Dec 19.
INTRODUCTION
Autoimmune disorders are chronic, self-mediated, misdirected immune responses against their own immune system. It required intensive, complex and costly drug treatment regimen increased the risk of pharmacotherapy error and adversely affects patients. Hence, pharmacist care will have vital roles in autoimmune disorders to achieve health related outcomes.
OBJECTIVES
This review aimed to gather evidence on the impact of pharmacist care on clinical, humanistic and economic outcomes, adherence to medications, and drug related problems in the management of autoimmune disorders among the usual care group.
METHODOLOGY
A comprehensive review conducted in compliance with the PRISMA statement and systematic search was performed across five databases included PubMed Central, Web of Sciences, Scopus, Cochrane Library andgoogle scholar from inception until August 2020. This research included full-text articles of randomized and non-randomized studies that evaluated impact of pharmacist care in autoimmune disorders.
RESULTS
A total of nine studies were included (seven RCTs and two non-RCTs), including 829 patients with autoimmune disorders. A total of four studies (80%) show an enhancement in at least one clinical parameter due to pharmacist care. A substantial improvement in at least one humanistic parameter observed in all five studies (100%). While four out of five studies (80%) clearly displayed a remarkable improvement in medication adherence in the pharmacist care group from baseline to the completion of follow-ups. One study quantified a 99.08% resolution of DRPs in the pharmacist care group. Another study estimated the cost of medical resources uses per patient and found no difference in cost-effectiveness over six months between groups.
CONCLUSION
This review reinforces the vital contribution of pharmacists to achieve clinical outcomes, humanistic outcomes, adherence to medications and DRPs in the efficient management of autoimmune disorders. However, no notable changes in economic outcomes were observed in this review.
简介
自身免疫性疾病是一种慢性的、自身介导的、针对自身免疫系统的免疫反应失调。它需要强化、复杂和昂贵的药物治疗方案，增加了药物治疗错误的风险，并对患者产生不利影响。因此，药剂师在自身免疫性疾病的管理中扮演着至关重要的角色，以实现与健康相关的结果。
目的
本综述旨在收集有关药剂师在常规护理组中管理自身免疫性疾病时对临床、人文和经济结果、药物依从性以及药物相关问题的影响的证据。
方法
根据 PRISMA 声明和系统搜索，对五个数据库（PubMed Central、Web of Sciences、Scopus、Cochrane Library 和 Google Scholar）进行了全面综述，检索时间从建库到 2020 年 8 月。本研究包括评价药剂师在自身免疫性疾病中的作用的随机和非随机研究的全文文章。
结果
共纳入 9 项研究（7 项 RCT 和 2 项非 RCT），共纳入 829 例自身免疫性疾病患者。共有 4 项研究（80%）显示由于药剂师的护理，至少有一个临床参数得到了改善。所有五项研究（100%）均观察到至少有一个人文参数显著改善。虽然五项研究中有四项（80%）清楚地显示在药剂师护理组中，从基线到随访结束，药物依从性显著提高。一项研究显示，药剂师护理组的药物相关问题（DRP）解决率为 99.08%。另一项研究估计了每位患者的医疗资源使用成本，发现在六个月内两组之间的成本效益没有差异。
结论
本综述强化了药剂师在高效管理自身免疫性疾病中实现临床结果、人文结果、药物依从性和 DRP 的重要贡献。然而，本综述未观察到经济结果有显著变化。
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