Terri V Newman1, Alvaro San-Juan-Rodriguez2, Natasha Parekh3, Elizabeth C S Swart4, Michele Klein-Fedyshin5, William H Shrank6, Inmaculada Hernandez7. 1. Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, PA, USA. Electronic address: tvn6@pitt.edu. 2. Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, PA, USA. Electronic address: als440@pitt.edu. 3. The Queen's Health System, Honolulu, HI, USA; University of Hawaii School of Medicine, Honolulu, HI, USA. Electronic address: parekhn@upmc.edu. 4. UPMC Center for High-Value Health Care, University of Pittsburgh Medical Center, PA, USA. Electronic address: swarte@upmc.edu. 5. Health Sciences Library System, University of Pittsburgh, PA, USA. Electronic address: kleinf@pitt.edu. 6. Humana Inc, KY, USA. Electronic address: willshrank@gmail.com. 7. Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, PA, USA. Electronic address: inh3@pitt.edu.
Abstract
BACKGROUND: Chronic disease represents a significant burden to the United States (US) health care system, with approximately 50% of all adults in the US having one or more chronic disease conditions. Pharmacist-led chronic disease management interventions are of special interest since 80% of medical treatments involve the use of prescription drugs. Moreover, community pharmacists are among the most accessible health care professionals to provide care for populations with chronic diseases. The impact of care provided by community pharmacists isn't well defined, with interventions taking on diverse forms with varied effects on outcomes. OBJECTIVE: The purpose of this review is to summarize evidence from secondary literature on community pharmacist-led chronic disease management interventions and the impact on clinical, utilization, and economic outcomes. METHODS: We conducted a systematic search of systematic reviews, meta-analyses, and narrative reviews using MEDLINE via PubMed, EMBASE.com and Cochrane Library databases published between January 1, 2007 and October 17, 2017. The following data were extracted: citation details, review type, number of primary studies included, disease state, description of the intervention, outcomes assessed, and results. RESULTS: Our search strategy retrieved 2296 titles and abstracts of which 15 references met our inclusion criteria. Selected articles covered 7 main diseases -diabetes, asthma, chronic obstructive pulmonary disease (COPD), hypertension, heart failure, hyperlipidemia, and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Community pharmacist-led interventions mostly consisted of patient consultations and education. In diabetes, interventions achieved significant reductions in hemoglobin A1c, total cholesterol, and low-density lipoprotein (LDL). Reviews also reported favorable reductions in blood pressure, improved medication adherence and reduced readmission rates in patients with heart failure, improved lung function in patients with respiratory conditions, and increased medication adherence in those with HIV/AIDs. Literature reporting economic and utilization outcomes were limited and mostly focused on pharmacy interventions in diabetes. In some cases, community pharmacy services demonstrated a decrease in medical and health care costs in patients with diabetes. CONCLUSION: We found that community pharmacists can improve clinical outcomes in a wide array of chronic diseases, including diabetes, hyperlipidemia, HIV/AIDS, cardiovascular and respiratory diseases. More robust studies are needed to further assess the impact of specific interventions on economic and utilization outcomes.
BACKGROUND: Chronic disease represents a significant burden to the United States (US) health care system, with approximately 50% of all adults in the US having one or more chronic disease conditions. Pharmacist-led chronic disease management interventions are of special interest since 80% of medical treatments involve the use of prescription drugs. Moreover, community pharmacists are among the most accessible health care professionals to provide care for populations with chronic diseases. The impact of care provided by community pharmacists isn't well defined, with interventions taking on diverse forms with varied effects on outcomes. OBJECTIVE: The purpose of this review is to summarize evidence from secondary literature on community pharmacist-led chronic disease management interventions and the impact on clinical, utilization, and economic outcomes. METHODS: We conducted a systematic search of systematic reviews, meta-analyses, and narrative reviews using MEDLINE via PubMed, EMBASE.com and Cochrane Library databases published between January 1, 2007 and October 17, 2017. The following data were extracted: citation details, review type, number of primary studies included, disease state, description of the intervention, outcomes assessed, and results. RESULTS: Our search strategy retrieved 2296 titles and abstracts of which 15 references met our inclusion criteria. Selected articles covered 7 main diseases -diabetes, asthma, chronic obstructive pulmonary disease (COPD), hypertension, heart failure, hyperlipidemia, and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Community pharmacist-led interventions mostly consisted of patient consultations and education. In diabetes, interventions achieved significant reductions in hemoglobin A1c, total cholesterol, and low-density lipoprotein (LDL). Reviews also reported favorable reductions in blood pressure, improved medication adherence and reduced readmission rates in patients with heart failure, improved lung function in patients with respiratory conditions, and increased medication adherence in those with HIV/AIDs. Literature reporting economic and utilization outcomes were limited and mostly focused on pharmacy interventions in diabetes. In some cases, community pharmacy services demonstrated a decrease in medical and health care costs in patients with diabetes. CONCLUSION: We found that community pharmacists can improve clinical outcomes in a wide array of chronic diseases, including diabetes, hyperlipidemia, HIV/AIDS, cardiovascular and respiratory diseases. More robust studies are needed to further assess the impact of specific interventions on economic and utilization outcomes.
Authors: Vivian Welch; Omar Dewidar; Elizabeth Tanjong Ghogomu; Salman Abdisalam; Abdulah Al Ameer; Victoria I Barbeau; Kevin Brand; Kisanet Kebedom; Maria Benkhalti; Elizabeth Kristjansson; Mohamad Tarek Madani; Alba M Antequera Martín; Christine M Mathew; Jessie McGowan; William McLeod; Hanbyoul Agatha Park; Jennifer Petkovic; Alison Riddle; Peter Tugwell; Mark Petticrew; Jessica Trawin; George A Wells Journal: Cochrane Database Syst Rev Date: 2022-01-18
Authors: M Rozaini Rosli; Chin F Neoh; David B Wu; Nazariah W Hassan; Mahani Mahmud; Afifah Rahimi; Mahmathi Karuppannan Journal: Pharm Pract (Granada) Date: 2021-09-09
Authors: Gloria Reig-Garcia; Rosa Suñer-Soler; Susana Mantas-Jiménez; Anna Bonmatí-Tomas; Maria Carmen Malagón-Aguilera; Cristina Bosch-Farré; Sandra Gelabert-Viella; Dolors Juvinyà-Canal Journal: Int J Environ Res Public Health Date: 2021-06-19 Impact factor: 3.390