An eleven-year review of the pharmacy literature: documentation of the value and acceptance of clinical pharmacy.

The primary objectives of the article were accomplished by providing both a bibliography of articles dealing with clinical pharmacy services in acute-care facilities and summaries of those constituting original research reports on clinical pharmacy services. However, in the process, we made the following interesting observations. We found that articles reporting impacts on cost, quality, and attitude numbered 48, 58, and 24, respectively. Most articles relating to drug therapy monitoring, with minor exceptions, dealt with either the quality or cost-savings impact or a combination of both. Also, articles concerning drug therapy monitoring comprised almost half of all those summarized (40 articles). Articles detailing drug information and education (category 2) numbered 28 and dealt mainly with attitudes or quality impacts with minor reference to cost-savings. It was also interesting, albeit expected, to observe that the bulk of attitudinal studies fell in category 2. We found category 5, controlling medication administration, had 13 articles, primarily concerned with cost and or quality. Category 4, reporting and detection of adverse drug reactions, contained a total of eight articles mainly studying the impact on quality. The other categories contained very few, if any, articles. From these results, it is evident that the profession has made significant strides in building a strong scientific data base to support the value of its clinical services. However, there is ample room for additional original research reports. Although it can be argued that alone many of the studies could not justify clinical pharmacy as cost-effective, organized as one reference they provide an invaluable resource. Although it might be unreasonable to expect each pharmacy department to be able to cost-justify its existence, this work presents the background data needed to begin or develop such efforts.