社区药剂师主导的药物审查方案对患者结局的影响：一项随机对照试验的系统评价和荟萃分析。
Impact of community-pharmacist-led medication review programmes on patient outcomes: A systematic review and meta-analysis of randomised controlled trials.
机构信息
Department of Pharmaceutical Practice, College of Pharmacy, Princess Nourah Bint Abdulrahaman University, Riyadh, Saudi Arabia; School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom.
School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom.
出版信息
Res Social Adm Pharm. 2022 Apr;18(4):2559-2568. doi: 10.1016/j.sapharm.2021.04.022. Epub 2021 Apr 29.
BACKGROUND
The role of pharmacists has evolved over the past few decades from being product-oriented to being service-oriented. Community-pharmacist-led medication review programmes have been commissioned in different countries under different names. The services provided by general pharmacists can have a positive impact on patient health, but the impact of the services offered by community pharmacists is relatively unknown.
OBJECTIVE
To evaluate the effectiveness of community-pharmacist-based medication review programmes among patients with long-term conditions.
METHODS
The electronic databases Cochrane Library, MEDLINE and Embase were searched from their inception until January 2020 for randomised controlled trials (RCTs) published in the English language assessing the effectiveness of community-pharmacist-led medication review programmes on patients' clinical and healthcare utilisation outcomes. Random-effects meta-analysis was used to pool data statistically, where applicable. The study protocol was published in PROSPERO (ID: CRD42020165693).
RESULTS
Forty-two reports of 40 RCTs were included in the systematic review, and 12 RCTs were included in the meta-analysis. Compared to the control, a significant improvement was noted in the community-pharmacist-based medication review group for the following outcomes: blood pressure (BP) in patients with diabetes (mean difference [MD] in systolic blood pressure [SBP]: 6.82 [95% CI -11.33, -2.32]; MD in diastolic blood pressure [DBP]: 2.13 [95% CI -3.35, -0.92]) and in the hypertension patients (MD in SBP: 6.21 [95% CI -13.26, 0.85]; MD in DBP: 2.11 [95% CI -6.47, 2.26]), HbA1c in patients with diabetes (MD -0.61; 95% CI -0.96, -0.25), and total cholesterol (TC) in patients with hyperlipidaemia (MD -0.18; 95% CI -0.32, -0.05).
CONCLUSION
Community-pharmacist-led medication review can improve certain clinical and healthcare utilisation outcomes in patients with long-term conditions.
背景
在过去的几十年里，药剂师的角色已经从以产品为导向转变为以服务为导向。不同国家以不同的名称委托社区药剂师主导的药物审查计划。一般药剂师提供的服务可以对患者的健康产生积极影响，但社区药剂师提供的服务的影响相对未知。
目的
评估以社区药剂师为基础的药物审查计划对患有慢性病的患者的有效性。
方法
从其成立到 2020 年 1 月，检索了 Cochrane Library、MEDLINE 和 Embase 电子数据库，以寻找评估社区药剂师主导的药物审查计划对患者临床和医疗保健利用结果的有效性的随机对照试验（RCT）。在适用的情况下，使用随机效应荟萃分析对数据进行统计合并。研究方案已在 PROSPERO（ID：CRD42020165693）上发表。
结果
系统评价纳入了 40 项 RCT 的 42 份报告，meta 分析纳入了 12 项 RCT。与对照组相比，以社区药剂师为基础的药物审查组在以下方面有显著改善：患有糖尿病的患者的血压（SBP 的平均差值 [MD]：-6.82 [95% CI -11.33, -2.32]；DBP 的 MD：2.13 [95% CI -3.35, -0.92]）和高血压患者（SBP 的 MD：-6.21 [95% CI -13.26, 0.85]；DBP 的 MD：2.11 [95% CI -6.47, 2.26]）、患有糖尿病的患者的糖化血红蛋白（MD：-0.61；95% CI -0.96, -0.25）和患有高脂血症的患者的总胆固醇（MD：-0.18；95% CI -0.32, -0.05）。
结论
以社区药剂师为主导的药物审查可以改善慢性病患者的某些临床和医疗保健利用结果。
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