TY - JOUR
T1 - The Impact of Pharmaceutical Care in Multidisciplinary Teams on Health Outcomes
T2 - Systematic Review and Meta-Analysis
AU - Ruiz-Ramos, Jesús
AU - Hernández, Marta H.
AU - Juanes-Borrego, Ana M.
AU - Milà, Raimon
AU - Mangues-Bafalluy, Maria A.
AU - Mestres, Conxita
N1 - Publisher Copyright:
© 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine
PY - 2021/12
Y1 - 2021/12
N2 - Objectives: Pharmacists’ care has an essential role in multidisciplinary teams in charge of chronic patients. However, data available on the clinical outcomes of these activities appear inconclusive. This study aimed to systematically investigate the effect of multidisciplinary teams that include coordinated pharmaceutical care on clinical outcomes. Design: Systematic review and meta-analysis. Relevant studies identified from MEDLINE, Cochrane, Web of Science, Scopus and CINAHL databases were analyzed. The search included randomized clinical trials published in 2000-2018. Included studies were all published studies in English that compared the effectiveness of multidisciplinary teams including pharmacist care to usual care. Meta-analysis was carried out using a random effects model, and subgroup analysis was conducted to determine the sources of heterogeneity. Setting and Participants: 29 studies involving 4186 adult patients were included. Measures: Follow-up time varied from 30 to 180 days. The most common primary endpoint was the frequency of hospitalizations or readmissions, followed by variation in clinical parameter variables related to quality of prescription, treatment adherence and costs. Results: Twelve (41.3%) of the included studies scored low risk of bias according to the AMSTAR-2 scale, the remaining 17 (58.7%) being classified as intermediate risk. The intervention of a multidisciplinary team reduced the probability of readmission by 32% [odds ratio (OR) 0.74, 95% confidence interval (CI) 0.62-0.89]. Six of the 29 (20.7%) studies included met the inclusion criteria of the meta-analysis on quality-of-life outcomes. The intervention of the multidisciplinary team represented a significant increase in patients’ quality of life (OR 0.58, 95% CI 0.47-0.69). Analysis of heterogeneity showed a significant difference between the studies. No evidence of publication bias was identified. Conclusions and Implications: Multidisciplinary programs that include pharmaceutical care reduce the risk of visiting hospitals and improve patients’ quality of life. This review supports the importance of the pharmacists as part of multidisciplinary teams.
AB - Objectives: Pharmacists’ care has an essential role in multidisciplinary teams in charge of chronic patients. However, data available on the clinical outcomes of these activities appear inconclusive. This study aimed to systematically investigate the effect of multidisciplinary teams that include coordinated pharmaceutical care on clinical outcomes. Design: Systematic review and meta-analysis. Relevant studies identified from MEDLINE, Cochrane, Web of Science, Scopus and CINAHL databases were analyzed. The search included randomized clinical trials published in 2000-2018. Included studies were all published studies in English that compared the effectiveness of multidisciplinary teams including pharmacist care to usual care. Meta-analysis was carried out using a random effects model, and subgroup analysis was conducted to determine the sources of heterogeneity. Setting and Participants: 29 studies involving 4186 adult patients were included. Measures: Follow-up time varied from 30 to 180 days. The most common primary endpoint was the frequency of hospitalizations or readmissions, followed by variation in clinical parameter variables related to quality of prescription, treatment adherence and costs. Results: Twelve (41.3%) of the included studies scored low risk of bias according to the AMSTAR-2 scale, the remaining 17 (58.7%) being classified as intermediate risk. The intervention of a multidisciplinary team reduced the probability of readmission by 32% [odds ratio (OR) 0.74, 95% confidence interval (CI) 0.62-0.89]. Six of the 29 (20.7%) studies included met the inclusion criteria of the meta-analysis on quality-of-life outcomes. The intervention of the multidisciplinary team represented a significant increase in patients’ quality of life (OR 0.58, 95% CI 0.47-0.69). Analysis of heterogeneity showed a significant difference between the studies. No evidence of publication bias was identified. Conclusions and Implications: Multidisciplinary programs that include pharmaceutical care reduce the risk of visiting hospitals and improve patients’ quality of life. This review supports the importance of the pharmacists as part of multidisciplinary teams.
KW - Patient team care
KW - Chronic disease
KW - Pharmacist
KW - Polypharmacy
UR - http://www.scopus.com/inward/record.url?scp=85110306123&partnerID=8YFLogxK
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pure_univeritat_ramon_llull&SrcAuth=WosAPI&KeyUT=WOS:000722129900019&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1016/j.jamda.2021.05.038
DO - 10.1016/j.jamda.2021.05.038
M3 - Review
C2 - 34228962
AN - SCOPUS:85110306123
SN - 1525-8610
VL - 22
SP - 2518
EP - 2526
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 12
ER -
