The impact of hospital-based post-discharge pharmacist medication review on patient clinical outcomes: A systematic review

被引:11
作者
Costello, Jaclyn [1 ,2 ]
Barras, Michael [1 ,3 ]
Foot, Holly [1 ]
Cottrell, Neil [1 ,4 ]
机构
[1] Univ Queensland, Sch Pharm, Brisbane, Qld, Australia
[2] Redcliffe Hosp, Pharm Dept, Metro North Hlth, Brisbane, Qld, Australia
[3] Princess Alexandra Hosp, Metro South Hlth, Pharm Dept, Brisbane, Qld, Australia
[4] Univ Queensland, Fac Hlth & Behav Sci, Brisbane, Qld, Australia
来源
EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY | 2023年 / 11卷
关键词
Pharmacist; Pharmacy; Pharmaceutical; Medication review; Medication therapy management; Patient discharge; Hospital outpatient clinics; Ambulatory care; Medicine*; Medication*; Review*; Service*; Clinic(s); 30-DAY READMISSION RATES; DRUG-RELATED PROBLEMS; HIGH-RISK PATIENTS; FOLLOW-UP VISITS; THERAPY MANAGEMENT; TRANSITIONAL CARE; DISCHARGE PROGRAM; AFTER-DISCHARGE; OLDER-PEOPLE; INTERVENTION;
D O I
10.1016/j.rcsop.2023.100305
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Background: Clinical pharmacists have been shown to identify and resolve medication related problems post-discharge, however the impact on patient clinical outcomes is unclear.Aims: To undertake a systematic review to identify, critically appraise and present the evidence on post-discharge hospital clinics that provide clinical pharmacist medication review; report the patient clinical outcomes measured; and describe the activities of the clinical pharmacist.Methods: Published studies evaluating a patient clinical outcome following a post-discharge hospital clinic pharmacy service were included. All studies needed a comparative design (intervention vs control or compar-ator). Pubmed, Embase, CINAHL, PsycnINFO, Web of Science, IPA and APAIS-Health databases were searched to identify studies. The type of clinic and the clinical pharmacist activities were linked to patient clinical outcomes.Results: Fifty-seven studies were included in the final analysis, 14 randomised controlled trials and 43 non-randomised studies. Three key clinic types were identified: post-discharge pharmacist review alone, inpatient care plus post-discharge review and post-discharge collaborative clinics. The three main outcome metrics identified were hospital readmission and/or representation, adverse events and improved disease state metrics. There was often a mix of these outcomes reported as primary and secondary outcomes. High heterogeneity of interventions and clinical pharmacist activities reported meant it was difficult to link clinical pharmacist ac-tivities with the outcomes reported.Conclusions: A post-discharge clinic pharmacist may improve patient clinical outcomes such as hospital read-mission and representation rates. Future research needs to provide a clearer description of the clinical pharmacist activities provided in both arms of comparative studies.
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页数:29
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