School of Pharmacy, University of East Anglia, Norwich, UK
School of Health Sciences, University of East Anglia, Norwich, UK.
BMJ Qual Saf. 2024 Nov 20;33(12):808-822. doi: 10.1136/bmjqs-2024-017283.
Pharmacist-led medication reviews are an established intervention to support patients prescribed multiple medicines or with complex medication regimes. For this systematic review, a medication review was defined as 'a consultation between a pharmacist and a patient to review the patient's total medicines use with a view to improve patient health outcomes and minimise medicines-related problems'. It is not known how varying approaches to medication reviews lead to different outcomes.
To explore the common themes associated with positive outcomes from pharmacist-led medication reviews.
Randomised controlled trials of pharmacist-led medication reviews in adults aged 18 years and over were included. The search terms used in MEDLINE, EMBASE and Web of Science databases were "medication review", "pharmacist", "randomised controlled trial" and their synonyms, time filter 2015 to September 2023. Studies published before 2015 were identified from a previous systematic review. Risk of bias was assessed using the Cochrane risk of bias 2 tool. Descriptions of medication reviews' components, implementation and outcomes were narratively synthesised to draw out common themes. Results are presented in tables.
Sixty-eight papers describing 50 studies met the inclusion criteria. Common themes that emerged from synthesis include collaborative working which may help reduce medicines-related problems and the number of medicines prescribed; patient involvement in goal setting and action planning which may improve patients' ability to take medicines as prescribed and help them achieve their treatment goals; additional support and follow-up, which may lead to improved blood pressure, diabetes control, quality of life and a reduction of medicines-related problems.
This systematic review identified common themes and components, for example, goal setting, action planning, additional support and follow-up, that may influence outcomes of pharmacist-led medication reviews. Researchers, health professionals and commissioners could use these for a comprehensive evaluation of medication review implementation.
CRD42020173907.
药剂师主导的药物审查是一种既定的干预措施，旨在支持同时服用多种药物或使用复杂药物治疗方案的患者。在本次系统综述中，药物审查被定义为“药剂师与患者之间的一次咨询，以审查患者的全部用药情况，旨在改善患者的健康结果并最大限度地减少与药物相关的问题”。目前尚不清楚药物审查方法的不同如何导致不同的结果。
探索与药剂师主导的药物审查带来积极结果相关的共同主题。
纳入了成年人（18 岁及以上）接受的药剂师主导的药物审查的随机对照试验。在 MEDLINE、EMBASE 和 Web of Science 数据库中使用的检索词为“药物审查”、“药剂师”、“随机对照试验”及其同义词，并设置时间过滤器为 2015 年至 2023 年 9 月。2015 年以前发表的研究则从之前的系统综述中确定。使用 Cochrane 偏倚风险 2 工具评估偏倚风险。对药物审查的组成部分、实施和结果进行叙述性综合，以得出共同主题。结果以表格形式呈现。
有 68 篇描述了 50 项研究的论文符合纳入标准。从综合分析中得出的共同主题包括协作工作，这可能有助于减少与药物相关的问题和处方药物的数量；患者参与目标设定和行动计划，这可能会提高患者按规定服药的能力并帮助他们实现治疗目标；额外的支持和随访，这可能会导致血压、糖尿病控制、生活质量的改善和减少与药物相关的问题。
本次系统综述确定了共同主题和组成部分，例如目标设定、行动计划、额外的支持和随访，这些因素可能会影响药剂师主导的药物审查的结果。研究人员、卫生专业人员和决策者可以使用这些因素来全面评估药物审查的实施情况。
PROSPERO 注册号：CRD42020173907。
