Pharmacist services for non-hospitalised patients

Area of Science:

• Pharmacology
• Health Services Research
• Evidence-Based Practice

Background:

• This review updates a previous Cochrane Review on non-dispensing services provided by community, primary, or ambulatory-care pharmacists to non-hospitalized patients.
• Focuses on pharmacist interventions beyond medication dispensing.

Purpose of the Study:

• To evaluate the impact of pharmacists' non-dispensing services on patient health outcomes.
• To compare pharmacist services against usual care and services provided by other healthcare professionals.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials.
• Searches conducted across multiple databases (CENTRAL, MEDLINE, Embase) and trial registers up to January 2018.
• Included 116 trials (39,729 participants vs. usual care; 2122 participants vs. other professionals), with 76 trials in meta-analyses.

Main Results:

• Pharmacist services may reduce out-of-target blood pressure (low-certainty evidence) and slightly improve physical functioning (low-certainty evidence).
• Evidence is uncertain regarding effects on glycated hemoglobin, hospital attendance/admissions, adverse drug effects, and mortality.
• No studies compared pharmacist services to other professionals for the main outcome measures.

Conclusions:

• Pharmacist non-dispensing services demonstrate varied effects on patient outcomes, with potential benefits in specific areas like blood pressure management.
• Significant heterogeneity in study populations, interventions, and outcomes necessitates cautious interpretation.
• Further research is needed, particularly comparative studies with other healthcare professionals for key patient outcomes.