Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
Pharmacy Department, Hamad Medical Cooperation, Doha, Qatar.
J Clin Pharm Ther. 2022 Jul;47(7):879-896. doi: 10.1111/jcpt.13633. Epub 2022 Mar 24.
The pharmacist's role has evolved dramatically over the last few decades and shows considerable impact globally. The aim of this systematic review was to describe the nature and extent of studies evaluating the impact of pharmacist-provided services on clinical, humanistic and economic outcomes in different healthcare settings across the Arab world.
A systematic literature search was conducted using the following databases from their inception until June 2020: Cochrane, Embase, MEDLINE, PubMed, ScienceDirect and Scopus. Reporting was done according to PRISMA guidelines, and the quality assessment utilized the Mixed Methods Appraisal Tool.
Thirty-five eligible studies were included in this review, the majority of which were randomized controlled trials (RCT) (n = 26) conducted in hospital settings (n = 26). Most of the studies involved patients with specific medical conditions (n = 29) and pharmacist's interventions involved mainly medication therapy management (n = 32), counselling and education (n = 29), and medication therapy recommendations (n = 12). Several studies showed a positive impact (i.e., a statistically and/or clinically significant difference in favour of pharmacist-provided care or intervention) of pharmacist-provided services on clinical (n = 28), humanistic (n = 6) and economic (n = 5) outcomes. Conversely, five studies showed neutral or mixed effect of pharmacist interventions on clinical and humanistic outcomes.
The findings of this systematic review demonstrate a positive impact of pharmacist-provided services on clinical, humanistic and economic outcomes across diverse settings in the Arab world. Most of the included studies evaluated clinical outcomes and were from hospital setting. Directed approaches are needed to advance pharmacy practice across various healthcare settings in the Arab world.
阿拉伯世界不同医疗环境下,药师提供服务对临床、人文和经济结局的影响:系统评价
目的:过去几十年,药师的角色发生了巨大变化,在全球范围内产生了重大影响。本系统评价旨在描述评估药师提供的服务对阿拉伯世界不同医疗环境下临床、人文和经济结局影响的研究的性质和范围。
方法:从各数据库创建开始至 2020 年 6 月,我们使用以下数据库进行系统文献检索:Cochrane、Embase、MEDLINE、PubMed、ScienceDirect 和 Scopus。报告符合 PRISMA 指南,质量评估使用混合方法评价工具。
结果与讨论:本综述纳入了 35 项合格研究,其中大多数为在医院环境中进行的随机对照试验(RCT)(n=26)。大多数研究涉及特定医疗条件的患者(n=29),药师干预主要涉及药物治疗管理(n=32)、咨询和教育(n=29)以及药物治疗建议(n=12)。几项研究表明(即,药师提供的护理或干预在临床(n=28)、人文(n=6)和经济(n=5)结局方面具有统计学和/或临床意义的差异),药师提供的服务对临床、人文和经济结局有积极影响。相反,五项研究显示药师干预对临床和人文结局的影响为中性或混合。
结论:本系统评价的结果表明,在阿拉伯世界不同环境下,药师提供的服务对临床、人文和经济结局有积极影响。大多数纳入的研究评估了临床结局,且来自医院环境。需要采取有针对性的方法来推动阿拉伯世界各种医疗环境下的药学实践。