A systematic review and meta-analysis of pharmacist-led fee-for-services medication review

Ernieda Md Hatah, Rhiannon Braund, June Tordoff, Stephen B. Duffull

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Aim The aim was to examine the impact of fee-for-service pharmacist-led medication review on patient outcomes and quantify this according to the type of review undertaken, e.g. adherence support and clinical medication review. Methods Relevant published studies were identified from Medline, Embase and International Pharmaceutical Abstract databases (from inception to February 2011). Study inclusion criteria were fee-for-service medication review, presence of a control group and pre-specified patient outcomes. Outcomes were grouped into primary (changes in biomarkers, hospitalization, and mortality) and secondary outcomes (medication adherence, economic implications and quality of life). Meta-analyses for primary outcomes were conducted using random effects models and secondary outcomes were summarized using descriptive statistics. Results Of the 135 relevant articles located, 21 studies met the inclusion criteria for primary outcomes and 32 for secondary outcomes. Significant results favouring pharmacists' intervention were found for blood pressure (OR 3.50, 95% CI 1.58, 7.75, P = 0.002) and low density lipoprotein (OR 2.35, 95% CI 1.17, 4.72, P = 0.02). Outcomes on hospitalization (OR 0.69, 95% CI 0.39, 1.21, P = 0.19) and mortality (OR 1.50, 95% CI 0.65 to 3.46, P = 0.34) indicated no differences between the groups. On subgroup analysis, clinical medication review (OR 0.46, 95% CI 0.26, 0.83, P = 0.01) but not adherence support review (OR 0.88, 95% CI 0.59, 1.32, P = 0.54) reduced hospitalization. Conclusions The majority of the studies (57.9%) showed improvement in medication adherence. Fee-for-service pharmacist-led medication reviews showed positive benefits on patient outcomes. Interventions that include a clinical review had a significant impact on patient outcomes by attainment of target clinical biomarkers and reduced hospitalization.

Original languageEnglish
Pages (from-to)102-115
Number of pages14
JournalBritish Journal of Clinical Pharmacology
Volume77
Issue number1
DOIs
Publication statusPublished - Jan 2014

Fingerprint

Fee-for-Service Plans
Pharmacists
Meta-Analysis
Hospitalization
Medication Adherence
Biomarkers
Pharmaceutical Databases
Mortality
LDL Lipoproteins
Economics
Quality of Life
Blood Pressure
Control Groups

Keywords

  • community pharmacy services
  • drug use review
  • hospitalization
  • medication review
  • medication therapy management
  • outcome assessment (health care)

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

Cite this

A systematic review and meta-analysis of pharmacist-led fee-for-services medication review. / Md Hatah, Ernieda; Braund, Rhiannon; Tordoff, June; Duffull, Stephen B.

In: British Journal of Clinical Pharmacology, Vol. 77, No. 1, 01.2014, p. 102-115.

Research output: Contribution to journalArticle

Md Hatah, Ernieda ; Braund, Rhiannon ; Tordoff, June ; Duffull, Stephen B. / A systematic review and meta-analysis of pharmacist-led fee-for-services medication review. In: British Journal of Clinical Pharmacology. 2014 ; Vol. 77, No. 1. pp. 102-115.
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