Impact of pharmacist interventions provided in the emergency department on quality use of medicines: a systematic review and meta-analysis

被引:20
作者
Atey, Tesfay Mehari [1 ]
Peterson, Gregory M. [1 ]
Salahudeen, Mohammed Saji [1 ]
Bereznicki, Luke R. [1 ]
Wimmer, Barbara C. [1 ]
机构
[1] Univ Tasmania, Sch Pharm & Pharmacol, Hobart, Tas, Australia
关键词
emergency department; medication errors; systematic review; MEDICATION ERRORS; CLINICAL PHARMACISTS; RECONCILIATION; CARE; ACCURACY;
D O I
10.1136/emermed-2021-211660
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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.
引用
收藏
页码:120 / 127
页数:8
相关论文
共 50 条
[21]   The impact of PM2.5 on asthma emergency department visits: a systematic review and meta-analysis [J].
Fan, Jingchun ;
Li, Shulan ;
Fan, Chunling ;
Bai, Zhenggang ;
Yang, Kehu .
ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH, 2016, 23 (01) :843-850
[22]   Delirium prevalence in emergency department patients: A systematic review and meta-analysis [J].
Wang, Yusi ;
Dai, Min ;
Chen, Xiaoli ;
Zhang, Jianna .
NURSING IN CRITICAL CARE, 2024, 29 (06) :1215-1223
[23]   Nexus of Quality Use of Medicines, Pharmacists' Activities, and the Emergency Department: A Narrative Review [J].
Atey, Tesfay Mehari ;
Peterson, Gregory M. ;
Salahudeen, Mohammed S. ;
Wimmer, Barbara C. .
PHARMACY, 2024, 12 (06)
[24]   Discharge instruction comprehension by older adults in the emergency department: A systematic review and meta-analysis [J].
Haimovich, Adrian D. ;
Mulqueen, Sydney ;
Carreras-Tartak, Jossie ;
Gettel, Cameron ;
Schonberg, Mara A. ;
Hastings, Susan N. ;
Carpenter, Christopher ;
Liu, Shan W. ;
Thomas, Stephen H. .
ACADEMIC EMERGENCY MEDICINE, 2024, 31 (11) :1165-1172
[25]   Pharmacist services in nursing homes: A systematic review and meta-analysis [J].
Lee, Shaun Wen Huey ;
Mak, Vivienne Sook Li ;
Tang, Yee Woon .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2019, 85 (12) :2668-2688
[26]   Humanistic and economic outcomes of pharmacist-provided medication review in the community-dwelling elderly: A systematic review and meta-analysis [J].
Loh, Z. W. R. ;
Cheen, M. H. H. ;
Wee, H. L. .
JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS, 2016, 41 (06) :621-633
[27]   Multifactorial falls prevention programmes for older adults presenting to the emergency department with a fall: systematic review and meta-analysis [J].
Morello, Renata Teresa ;
Soh, Sze-Ee ;
Behm, Kate ;
Egan, Amy ;
Ayton, Darshini ;
Hill, Keith ;
Flicker, Leon ;
Etherton-Beer, Christopher D. ;
Arendts, Glenn ;
Waldron, Nicholas ;
Redfern, Julie ;
Haines, Terrence ;
Lowthian, Judy ;
Nyman, Samuel R. ;
Cameron, Peter ;
Fairhall, Nicola ;
Barker, Anna Lucia .
INJURY PREVENTION, 2019, 25 (06) :557-564
[28]   What is the prevalence of frequent attendance to emergency departments and what is the impact on emergency department utilisation? A systematic review and meta-analysis [J].
Shannon, Brendan ;
Pang, Rebecca ;
Jepson, Megan ;
Williams, Cylie ;
Andrew, Nadine ;
Smith, Karen ;
Bowles, Kelly-Ann .
INTERNAL AND EMERGENCY MEDICINE, 2020, 15 (07) :1303-1316
[29]   Interventions to improve the quality of low back pain care in emergency departments: a systematic review and meta-analysis [J].
Flanagan, Pippa ;
Waller, Robert ;
Lin, Ivan ;
Richards, Karen ;
Truter, Piers ;
Machado, Gustavo C. ;
Cavalheri, Vinicius .
INTERNAL AND EMERGENCY MEDICINE, 2024, 19 (07) :2057-2076
[30]   What is the prevalence of frequent attendance to emergency departments and what is the impact on emergency department utilisation? A systematic review and meta-analysis [J].
Brendan Shannon ;
Rebecca Pang ;
Megan Jepson ;
Cylie Williams ;
Nadine Andrew ;
Karen Smith ;
Kelly-Ann Bowles .
Internal and Emergency Medicine, 2020, 15 :1303-1316