Nancy Nkansah|Olga Mostovetsky|Christine Yu|Tami Chheng|Johnny Beney|Christine Bond|Lisa Bero
Effect of outpatient pharmacists' non-dispensing roles on patient outcomes and prescribing patterns
California State University, Fresno|University of California, San Francisco|University of California, San Francisco|University of California, San Francisco|University of California, San Francisco|Hôpital du Valais|University of Aberdeen|University of California, San Francisco
roles pharmacists patient care expanded traditional tasks dispensing medications providing basic medication counseling working health professionals public multiple reviews evaluated impact pharmacistprovided patient care healthrelated outcomes prior reviews primarily focused inpatient settings systematic review focuses services provided outpatient pharmacists community ambulatory care settings update cochrane review published 2000to examine effect outpatient pharmacists nondispensing roles patient health professional outcomesthis review split two phases phase searched cochrane effective practice organisation care epoc group specialised register january 1966 march 2007 phase ii searched medlineembase january 1966 march 2008 phase results reported review phase ii summarized next updaterandomized controlled trials comparing 1 pharmacist services targeted patients versus services delivered health professionals 2 pharmacist services targeted patients versus delivery comparable service 3 pharmacist services targeted health professionals versus services delivered health professionals 4 pharmacist services targeted health professionals versus delivery comparable servicetwo authors independently reviewed studies inclusion extracted data assessed risk bias included studiesfortythree studies included 36 studies pharmacist interventions targeting patients seven studies pharmacist interventions targeting health professionals comparison 1 included study showed significant improvement systolic blood pressure patients receiving medication management pharmacist compared usual care physician comparison 2 five studies evaluating process care outcomes pharmacist services reduced incidence therapeutic duplication decreased total number medications prescribed twentynine 36 studies reported clinical humanistic outcomes pharmacist interventions resulted improvement clinical outcomes although improvements always statistically significant eight studies reported patient quality life outcomes three studies showed improvement least three subdomains comparison 3 studies identified meeting inclusion criteria comparison 4 two seven studies demonstrated clear statistically significant improvement prescribing patternsonly one included study compared pharmacist services health professional services hence unable draw conclusions regarding comparisons 1 3 included studies supported role pharmacists medicationtherapeutic management patient counseling providing health professional education goal improving patient process care clinical outcomes educational outreach visits physician prescribing patterns great heterogeneity types outcomes measured across studies therefore standardized approach measure report clinical humanistic process outcomes future randomized controlled studies evaluating impact outpatient pharmacists needed heterogeneity study comparison groups outcomes measures makes challenging make generalised statements regarding impact pharmacists specific settings disease states patient populations