The Impact of Pharmaceutical Care in Multidisciplinary Teams on Health Outcomes: Systematic Review and Meta-Analysis
Autor: | Hernandez, MH, Juanes-Borrego, AM, Mila, R, Mangues-Bafalluy, MA, Mestres, C |
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Rok vydání: | 2021 |
Předmět: | |
Zdroj: | Journal of the American Medical Directors Association r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
ISSN: | 1525-8610 |
Popis: | Objectives: Pharmacists' care has an essential role in multidisciplinary teams in charge of chronic pa-tients. However, data available on the clinical outcomes of these activities appear inconclusive. This study aimed to systematically investigate the effect of multidisciplinary teams that include coordinated pharmaceutical care on clinical outcomes. Design: Systematic review and meta-analysis. Relevant studies identified from MEDLINE, Cochrane, Web of Science, Scopus and CINAHL databases were analyzed. The search included randomized clinical trials published in 2000-2018. Included studies were all published studies in English that compared the effectiveness of multidisciplinary teams including pharmacist care to usual care. Meta-analysis was carried out using a random effects model, and subgroup analysis was conducted to determine the sources of heterogeneity. Setting and Participants: 29 studies involving 4186 adult patients were included. Measures: Follow-up time varied from 30 to 180 days. The most common primary endpoint was the frequency of hospitalizations or readmissions, followed by variation in clinical parameter variables related to quality of prescription, treatment adherence and costs. Results: Twelve (41.3%) of the included studies scored low risk of bias according to the AMSTAR-2 scale, the remaining 17 (58.7%) being classified as intermediate risk. The intervention of a multidisciplinary team reduced the probability of readmission by 32% [odds ratio (OR) 0.74, 95% confidence interval (CI) 0.62-0.89]. Six of the 29 (20.7%) studies included met the inclusion criteria of the meta-analysis on quality-of-life outcomes. The intervention of the multidisciplinary team represented a significant in-crease in patients' quality of life (OR 0.58, 95% CI 0.47-0.69). Analysis of heterogeneity showed a sig-nificant difference between the studies. No evidence of publication bias was identified. Conclusions and Implications: Multidisciplinary programs that include pharmaceutical care reduce the risk of visiting hospitals and improve patients' quality of life. This review supports the importance of the pharmacists as part of multidisciplinary teams. (c) 2021 AMDA -The Society for Post-Acute and Long-Term Care Medicine. |
Databáze: | OpenAIRE |
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