Multifaceted Pharmacist-led Interventions in the Hospital Setting: A Systematic Review

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Clinical pharmacy services often comprise complex interventions. In this MiniReview, we conducted a systematic review aiming to evaluate the impact of multifaceted pharmacist-led interventions in a hospital setting. We searched MEDLINE, Embase, Cochrane Library and CINAHL for peer-reviewed articles published from 2006 to 1 March 2018. Controlled trials concerning hospitalized patients in any setting receiving patient-related multifaceted pharmacist-led interventions were considered. All types of outcomes were accepted. Inclusion and data extraction was performed. Study characteristics were collected and risk of bias assessment was conducted utilising the Cochrane Risk of Bias tools. All stages were conducted by at least two independent reviewers. The review was registrered in PROSPERO (CRD42017075808). A total of 11,986 publications were identified and 28 publications were included. Of these, 17 were conducted in Europe. Six of the included publications were multicentre studies and 16 were randomized trials. Usual care was the comparator. Significant results on quality of medication use were reported as positive in eleven studies (N=18; 61%) and negative in one (N=18, 6%). Hospital visits were reduced significantly in seven studies (N=16; 44%). Four studies (N=12; 33%) reported a positive significant effect on either length of stay or time to revisit, and one study reported a negative effect (N=12; 6%). All studies investigating mortality (N=6), patient-reported outcomes (N=7), and cost-effectiveness (N=1) showed no significant results. This rMiniReview indicates that multifaceted pharmacist-led interventions in a hospital setting may improve the quality of medication use, reduce hospital visits and length of stay, while no effect was seen on mortality, patient-reported outcomes and cost-effectiveness. This article is protected by copyright. All rights reserved.

JournalBasic & Clinical Pharmacology & Toxicology Online
StateE-pub ahead of print - 3 May 2018