Department of Pharmacy, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
Int J Pharm Pract. 2023 Dec 19;31(6):574-584. doi: 10.1093/ijpp/riad049.
To summarise the extent and type of evidence available regarding economic evaluations of adult critical care pharmacy services in the context of UK practice.
A literature search was conducted in eight electronic databases and hand searching of full-text reference lists. Of 2409 journal articles initially identified, 38 were included in the final review. Independent literature review was undertaken by two investigators in a two-step process against the inclusion and exclusion criteria; title and abstract screening were followed by full-text screening. Included studies were taken from high-income economy countries that contained economic data evaluating any key aspect of adult critical care pharmacy services. Grey literature and studies that could not be translated into the English language were excluded.
The majority were before-and-after studies (18, 47%) or other observational studies (17, 45%), and conducted in North America (25, 66%). None of the included studies were undertaken in the UK. Seven studies (18%) included cost-benefit analysis; all demonstrated positive cost-benefit values for clinical pharmacist activities.
Further high-quality primary research focussing on the economic evaluation of UK adult critical care pharmacy services is needed, before undertaking a future systematic review. There is an indication of a cost-benefit value for critical care pharmacist activities. The lack of UK-based economic evaluations is a limitation to further development and standardisation of critical care pharmacy services nationally.
总结英国实践中成人重症监护药房服务经济评估的现有证据的范围和类型。
在八个电子数据库中进行文献检索,并对手头的全文参考文献进行手工搜索。在最初确定的 2409 篇期刊文章中,有 38 篇被纳入最终综述。两名研究人员按照纳入和排除标准,以两步法进行独立的文献回顾;先进行标题和摘要筛选,然后进行全文筛选。纳入的研究来自高收入经济体,包含评估成人重症监护药房服务任何关键方面的经济数据。排除灰色文献和无法翻译成英文的研究。
大多数为前后对照研究(18,47%)或其他观察性研究(17,45%),且均在北美进行(25,66%)。纳入的研究均未在英国进行。7 项研究(18%)包括成本效益分析;所有研究均表明临床药师活动具有正的成本效益值。
在进行未来的系统评价之前,需要进一步开展针对英国成人重症监护药房服务的高质量初级研究,以评估其经济价值。重症监护药师活动具有成本效益。缺乏基于英国的经济评估是限制全国范围内重症监护药房服务进一步发展和标准化的一个局限。