Literature DB >> 17712043

Sensitivity of patient outcomes to pharmacist interventions. Part I: systematic review and meta-analysis in diabetes management.

Márcio Machado1, Jana Bajcar, Giovanni C Guzzo, Thomas R Einarson.   

Abstract

BACKGROUND: Pharmacists participate in managing diabetes therapy. Despite many reviews, few have quantified the impact of pharmacists' interventions.
OBJECTIVES: To identify outcomes sensitive to pharmacists' interventions and quantify their impact through critical literature review.
METHODS: All original research describing the impact of pharmacists' interventions in the management of diabetic pharmacotherapy was sought in International Pharmaceutical Abstracts, MEDLINE, Embase, Cochrane Register, and Cumulative Index to Nursing & Allied Health Literature from inception through 2006. Two independent reviewers identified articles, compared results, and settled differences through consensus. The Downs-Black scale was used to assess quality. Data included intervention type, patient numbers, demographics, study characteristics, instruments used, data compared, and outcomes reported. A random-effects meta-analysis combined amenable results.
RESULTS: Of 302 articles identified, 108 involved pharmacists' interventions; 36 addressed diabetes (14 medical clinics, 11 community pharmacies, 7 ambulatory care clinics, 4 hospital wards, 1 physician's office, 1 prison, and 3 in both medical clinics and community pharmacies; 1 did not describe its practice site). Research designs included randomized (n = 18) and nonrandomized (n = 9) controlled trials, pre- and postobservational cohorts (n = 2), retrospective cohort study (n = 1), chart reviews (n = 5), and database study (n = 1). Diabetes education (69%) and medication management (61%) were the most frequently used interventions. Mean +/- SD quality was 62 +/- 11% (fair). Fifty-one (69%) study results were sensitive. Meta-analysis of data from 2247 patients in 16 studies found a significant reduction in hemoglobin A1C (A1C) levels in the pharmacists' intervention group (1.00 +/- 0.28%; p < 0.001) but not in controls (0.28 +/- 0.29%; p = 0.335). Pharmacists' interventions further reduced A1C values 0.62 +/- 0.29% (p = 0.03) over controls.
CONCLUSIONS: A1C is sensitive to pharmacists' interventions. Several potentially sensitive outcomes were identified, but too few studies were available for quantitative summaries. More research is needed.

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Year:  2007        PMID: 17712043     DOI: 10.1345/aph.1K151

Source DB:  PubMed          Journal:  Ann Pharmacother        ISSN: 1060-0280            Impact factor:   3.154


  80 in total

Review 1.  An analysis of quality of systematic reviews on pharmacist health interventions.

Authors:  Ana Carolina Melchiors; Cassyano Januário Correr; Rafael Venson; Roberto Pontarolo
Journal:  Int J Clin Pharm       Date:  2011-12-20

Review 2.  Review of services provided by pharmacies that promote healthy living.

Authors:  David Brown; Jane Portlock; Paul Rutter
Journal:  Int J Clin Pharm       Date:  2012-04-17

3.  Pharmacy students' approaches to learning in undergraduate and graduate entry programs.

Authors:  Lorraine Smith; Ines Krass; Erica Sainsbury; Grenville Rose
Journal:  Am J Pharm Educ       Date:  2010-08-10       Impact factor: 2.047

4.  Clinical pharmacists and basic scientists: do patients and physicians need this collaboration?

Authors:  Amir H Zargarzadeh; Susan Jacob; Roger S Klotz; Fadi T Khasawneh
Journal:  Int J Clin Pharm       Date:  2011-12

5.  Report of the 2009-2010 Professional Affairs Committee: pharmacist integration in primary care and the role of academic pharmacy.

Authors:  Seena L Haines; Renee M DeHart; Karl M Hess; Macary Weck Marciniak; Jeanine K Mount; Beth Bryles Phillips; Joseph J Saseen; Arlene A Flynn; S Whitney Zatzkin
Journal:  Am J Pharm Educ       Date:  2010-12-15       Impact factor: 2.047

6.  Implementation of medication review with follow-up in a Spanish community pharmacy and its achieved outcomes.

Authors:  Carla Castrillon Ocampo; Victoria Garcia-Cardenas; Fernando Martinez-Martinez; Shalom I Benrimoj; Pedro Amariles; Miguel Angel Gastelurrutia
Journal:  Int J Clin Pharm       Date:  2015-06-04

7.  The Role of Team-Based Care Involving Pharmacists to Improve Cardiovascular and Renal Outcomes.

Authors:  Lauren Odum; Adam Whaley-Connell
Journal:  Cardiorenal Med       Date:  2012-08-17       Impact factor: 2.041

8.  Cost analysis for the implementation of a medication review with follow-up service in Spain.

Authors:  Aranzazu Noain; Victoria Garcia-Cardenas; Miguel Angel Gastelurrutia; Amaia Malet-Larrea; Fernando Martinez-Martinez; Daniel Sabater-Hernandez; Shalom I Benrimoj
Journal:  Int J Clin Pharm       Date:  2017-04-22

9.  Pharmaceutical care of adolescents with diabetes mellitus type 1: the DIADEMA study, a randomized controlled trial.

Authors:  Emina Obarcanin; Manfred Krüger; Petra Müller; Verena Nemitz; Holger Schwender; Snijezana Hasanbegovic; Sena Kalajdzisalihovic; Stephanie Läer
Journal:  Int J Clin Pharm       Date:  2015-04-28

10.  Reasons for and time to discontinuation of rimonabant therapy: a modified prescription-event monitoring study.

Authors:  Marjolein J C Willemen; Aukje K Mantel-Teeuwisse; Yvonne Buggy; Deborah Layton; Sabine M J M Straus; Hubert G M Leufkens; Toine C G Egberts
Journal:  Drug Saf       Date:  2012-12-01       Impact factor: 5.606

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