Documented effectiveness of clinical pharmacy services

Articles documenting the effectiveness of clinical pharmacy services were reviewed and categorized. A list of articles describing clinical pharmacy services published in the primary pharmacy literature or presented at ASHP Midyear Clinical Meetings was prepared. Selected articles were evaluated further for documented evidence of the impact of these services on patient care. Impact was defined as any one of the following outcomes: decreased morbidity (side effects, toxicity, or adverse drug reactions), decreased mortality, improved prescribing or monitoring practices, improved therapeutic outcome, and increased compliance. Ongoing clinical pharmacy services were described in 144 meeting abstracts and 117 published papers. Of the 33 papers suitable for further review, 16 provided documentation of probable or definite impact on patient care as a result of clinical pharmacy services. Three types of clinical services were provided: patient education and counseling, pharmacokinetic monitoring, and clinical drug monitoring and information. Nine studies involved ambulatory patients; eight of these involved adult patients, while one used pediatric patients. Seven of the nine studies demonstrated increased compliance through patient education and counseling. Seven studies involved adult hospitalized patients. More well-designed studies documenting the effects of clinical pharmacy services on patient outcome are needed.