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

Area of Science:

• Clinical Pharmacy
• Health Services Research
• Systematic Review

Background:

• Clinical pharmacy services are complex interventions.
• Pharmacist-led interventions are increasingly implemented in hospital settings.
• Evaluating the impact of multifaceted interventions is crucial for optimizing patient care.

Purpose of the Study:

• To systematically review the impact of multifaceted pharmacist-led interventions in hospital settings.
• To assess effects on medication use quality, hospital visits, length of stay, mortality, patient-reported outcomes, and cost-effectiveness.

Main Methods:

• Systematic literature search of MEDLINE, Embase, Cochrane Library, and CINAHL (2006-2018).
• Inclusion of controlled trials of hospitalized patients receiving multifaceted pharmacist-led interventions.
• Data extraction and risk of bias assessment by independent reviewers.

Main Results:

• Twenty-eight studies were included; 17 from Europe, 16 randomized trials.
• Positive impact on medication use quality (61%), reduced hospital visits (44%), and improved length of stay/revisit time (33%).
• No significant effects observed on mortality, patient-reported outcomes, or cost-effectiveness.

Conclusions:

• Multifaceted pharmacist-led interventions show potential to enhance medication use quality and reduce hospital resource utilization.
• Further research may be needed to demonstrate impact on mortality, patient-reported outcomes, and cost-effectiveness.
• These findings support the integration of comprehensive pharmacist services in hospital care.