Impact of pharmacist interventions provided in the emergency department on quality use of medicines: a systematic review and meta-analysis.
| Autor: | Atey TM; School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia tesfaymehari.atey@utas.edu.au., Peterson GM; School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia., Salahudeen MS; School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia., Bereznicki LR; School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia., Wimmer BC; School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia. |
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| Jazyk: | angličtina |
| Zdroj: | Emergency medicine journal : EMJ [Emerg Med J] 2023 Feb; Vol. 40 (2), pp. 120-127. Date of Electronic Publication: 2022 Aug 01. |
| DOI: | 10.1136/emermed-2021-211660 |
| Abstrakt: | Background: Pharmacists have an increasing role as part of the emergency department (ED) team. However, the impact of ED-based pharmacy interventions on the quality use of medicines has not been well characterised. Objective: This systematic review aimed to synthesise evidence from studies examining the impact of interventions provided by pharmacists on the quality use of medicines in adults presenting to ED. Methods: A systematic literature search was conducted in MEDLINE, EMBASE and CINAHL. Two independent reviewers screened titles/abstracts and reviewed full texts. Studies that compared the impact of interventions provided by pharmacists with usual care in ED and reported medication-related primary outcomes were included. Cochrane Risk of Bias-2 and Newcastle-Ottawa tools were used to assess the risk of bias. Summary estimates were pooled using random-effects meta-analysis, along with sensitivity and sub-group analyses. Results: Thirty-one studies involving 13 242 participants were included. Pharmacists were predominantly involved in comprehensive medication review, advanced pharmacotherapy assessment, staff and patient education, identification of medication discrepancies and drug-related problems, medication prescribing and co-prescribing, and medication preparation and administration. The activities reduced the number of medication errors by a mean of 0.33 per patient (95% CI -0.42 to -0.23, I 2 =51%) and the proportion of patients with at least one error by 73% (risk ratio (RR)=0.27, 95% CI 0.19 to 0.40, I 2 =85.3%). The interventions were also associated with more complete and accurate medication histories, increased appropriateness of prescribed medications by 58% (RR=1.58, 95% CI 1.21 to 2.06, I 2 =95%) and quicker initiation of time-critical medications. Conclusion: The evidence indicates improved quality use of medicines when pharmacists are included in ED care teams. Prospero Registration Number: CRD42020165234. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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