Humanistic and economic outcomes of pharmacist-provided medication review in the community-dwelling elderly: A systematic review and meta-analysis
Summary What is known and objective Recent reviews have shown that pharmacist‐provided medication review in the elderly can improve clinical outcomes and reduce medication discrepancies compared with usual care. However, none determined whether these translate to improved humanistic and economic out...
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| Veröffentlicht in: | Journal of clinical pharmacy and therapeutics 2016-12, Vol.41 (6), p.621-633 |
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| creator | Loh, Z. W. R. Cheen, M. H. H. Wee, H. L. |
| description | Summary
What is known and objective
Recent reviews have shown that pharmacist‐provided medication review in the elderly can improve clinical outcomes and reduce medication discrepancies compared with usual care. However, none determined whether these translate to improved humanistic and economic outcomes. This review sought to evaluate the effects of medication review on health‐related quality of life (HRQoL) and healthcare costs in the elderly.
Methods
A systematic search of MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane library for studies published in English from inception to 31 August 2015 was conducted. The review included studies lasting at least 3 months that randomly assigned community‐dwelling participants aged at least 65 years to receive either pharmacist‐provided medication review or usual care. Studies set in nursing homes were excluded.
Results and discussion
The review identified 25 studies that included 15 341 participants and lasted between 3 and 36 months. Twenty and 13 studies reported HRQoL and economic outcomes, respectively. Overall, there was no significant difference in HRQoL and healthcare costs between pharmacist‐provided medication review and usual care. Meta‐analysis of studies that reported the 36‐item Short‐Form Health Survey found significant differences in favour of usual care in the body pain (mean difference: 2·94, 95% CI: 0·54–5·34, P = 0·02) and general health perception (mean difference: 1·83, 95% CI: 0·16–3·50, P = 0·03) domains, whereas there were no significant differences in other domains. Meta‐analysis of the EuroQol‐5D utility (mean difference: −0·01, 95% CI: −0·02–0·01, P = 0·57) and visual analogue scale (mean difference: 0·01, 95% CI: −3·24–3·26, P = 1·00) found no significant differences. Costs of hospitalization, medication and other healthcare resources consumed were similar between groups.
What is new and conclusion
Humanistic and economic outcomes of pharmacist‐provided medication review were largely similar to those of usual care. Further research using more robust methodology is needed to determine whether improved medication management can improve HRQoL and reduce healthcare costs. Careful thought should be given to capturing relevant outcomes that reflect the potential benefits of this intervention.
A systematic search of the literature was conducted to assess the impact of pharmacist‐provided medication review on health‐related quality of life (HRQoL) and healthcare cost in the elderly. The |
| doi_str_mv | 10.1111/jcpt.12453 |
| format | Article |
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What is known and objective
Recent reviews have shown that pharmacist‐provided medication review in the elderly can improve clinical outcomes and reduce medication discrepancies compared with usual care. However, none determined whether these translate to improved humanistic and economic outcomes. This review sought to evaluate the effects of medication review on health‐related quality of life (HRQoL) and healthcare costs in the elderly.
Methods
A systematic search of MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane library for studies published in English from inception to 31 August 2015 was conducted. The review included studies lasting at least 3 months that randomly assigned community‐dwelling participants aged at least 65 years to receive either pharmacist‐provided medication review or usual care. Studies set in nursing homes were excluded.
Results and discussion
The review identified 25 studies that included 15 341 participants and lasted between 3 and 36 months. Twenty and 13 studies reported HRQoL and economic outcomes, respectively. Overall, there was no significant difference in HRQoL and healthcare costs between pharmacist‐provided medication review and usual care. Meta‐analysis of studies that reported the 36‐item Short‐Form Health Survey found significant differences in favour of usual care in the body pain (mean difference: 2·94, 95% CI: 0·54–5·34, P = 0·02) and general health perception (mean difference: 1·83, 95% CI: 0·16–3·50, P = 0·03) domains, whereas there were no significant differences in other domains. Meta‐analysis of the EuroQol‐5D utility (mean difference: −0·01, 95% CI: −0·02–0·01, P = 0·57) and visual analogue scale (mean difference: 0·01, 95% CI: −3·24–3·26, P = 1·00) found no significant differences. Costs of hospitalization, medication and other healthcare resources consumed were similar between groups.
What is new and conclusion
Humanistic and economic outcomes of pharmacist‐provided medication review were largely similar to those of usual care. Further research using more robust methodology is needed to determine whether improved medication management can improve HRQoL and reduce healthcare costs. Careful thought should be given to capturing relevant outcomes that reflect the potential benefits of this intervention.
A systematic search of the literature was conducted to assess the impact of pharmacist‐provided medication review on health‐related quality of life (HRQoL) and healthcare cost in the elderly. The review included 26 articles involving 15 440 participants. The studies had several methodological issues that predisposed them to bias. Current evidence suggests that pharmacist‐provided medication review has similar effects as usual care in terms of its impact on HRQoL and healthcare cost in the elderly.</description><identifier>ISSN: 0269-4727</identifier><identifier>EISSN: 1365-2710</identifier><identifier>DOI: 10.1111/jcpt.12453</identifier><identifier>PMID: 27696540</identifier><identifier>CODEN: JCPTED</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Aged ; Community Pharmacy Services - economics ; costs ; elderly ; Health Care Costs ; Hospitalization - economics ; Humans ; Pharmacists ; Prescription Drugs - economics ; Prescription Drugs - therapeutic use ; Quality of Life ; systematic review</subject><ispartof>Journal of clinical pharmacy and therapeutics, 2016-12, Vol.41 (6), p.621-633</ispartof><rights>2016 John Wiley & Sons Ltd</rights><rights>2016 John Wiley & Sons Ltd.</rights><rights>Copyright © 2016 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4643-391f6ba49ed0369b4e0c397e7b68125e6a19eae1ef3321d4f9ba78ea29a8ca603</citedby><cites>FETCH-LOGICAL-c4643-391f6ba49ed0369b4e0c397e7b68125e6a19eae1ef3321d4f9ba78ea29a8ca603</cites><orcidid>0000-0003-1108-1494</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjcpt.12453$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjcpt.12453$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27696540$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Loh, Z. W. R.</creatorcontrib><creatorcontrib>Cheen, M. H. H.</creatorcontrib><creatorcontrib>Wee, H. L.</creatorcontrib><title>Humanistic and economic outcomes of pharmacist-provided medication review in the community-dwelling elderly: A systematic review and meta-analysis</title><title>Journal of clinical pharmacy and therapeutics</title><addtitle>J Clin Pharm Ther</addtitle><description>Summary
What is known and objective
Recent reviews have shown that pharmacist‐provided medication review in the elderly can improve clinical outcomes and reduce medication discrepancies compared with usual care. However, none determined whether these translate to improved humanistic and economic outcomes. This review sought to evaluate the effects of medication review on health‐related quality of life (HRQoL) and healthcare costs in the elderly.
Methods
A systematic search of MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane library for studies published in English from inception to 31 August 2015 was conducted. The review included studies lasting at least 3 months that randomly assigned community‐dwelling participants aged at least 65 years to receive either pharmacist‐provided medication review or usual care. Studies set in nursing homes were excluded.
Results and discussion
The review identified 25 studies that included 15 341 participants and lasted between 3 and 36 months. Twenty and 13 studies reported HRQoL and economic outcomes, respectively. Overall, there was no significant difference in HRQoL and healthcare costs between pharmacist‐provided medication review and usual care. Meta‐analysis of studies that reported the 36‐item Short‐Form Health Survey found significant differences in favour of usual care in the body pain (mean difference: 2·94, 95% CI: 0·54–5·34, P = 0·02) and general health perception (mean difference: 1·83, 95% CI: 0·16–3·50, P = 0·03) domains, whereas there were no significant differences in other domains. Meta‐analysis of the EuroQol‐5D utility (mean difference: −0·01, 95% CI: −0·02–0·01, P = 0·57) and visual analogue scale (mean difference: 0·01, 95% CI: −3·24–3·26, P = 1·00) found no significant differences. Costs of hospitalization, medication and other healthcare resources consumed were similar between groups.
What is new and conclusion
Humanistic and economic outcomes of pharmacist‐provided medication review were largely similar to those of usual care. Further research using more robust methodology is needed to determine whether improved medication management can improve HRQoL and reduce healthcare costs. Careful thought should be given to capturing relevant outcomes that reflect the potential benefits of this intervention.
A systematic search of the literature was conducted to assess the impact of pharmacist‐provided medication review on health‐related quality of life (HRQoL) and healthcare cost in the elderly. The review included 26 articles involving 15 440 participants. The studies had several methodological issues that predisposed them to bias. Current evidence suggests that pharmacist‐provided medication review has similar effects as usual care in terms of its impact on HRQoL and healthcare cost in the elderly.</description><subject>Aged</subject><subject>Community Pharmacy Services - economics</subject><subject>costs</subject><subject>elderly</subject><subject>Health Care Costs</subject><subject>Hospitalization - economics</subject><subject>Humans</subject><subject>Pharmacists</subject><subject>Prescription Drugs - economics</subject><subject>Prescription Drugs - therapeutic use</subject><subject>Quality of Life</subject><subject>systematic review</subject><issn>0269-4727</issn><issn>1365-2710</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAUhS0EotPChgdAltigSin-SeyEXQm0BVXlR4NYWo5zQz3E8WAnHfIaPDGezrQLFghvLEvfOfceH4SeUXJC03m1MuvxhLK84A_QgnJRZExS8hAtCBNVlksmD9BhjCtCiJCMP0YHTIpKFDlZoN8Xk9ODjaM1WA8tBuMH79LDT6PxDiL2HV5f6-C0SVS2Dv7GttBiB601erR-wAFuLGywHfB4DTip3DTYcc7aDfS9Hb5j6FsI_fwan-I4xxGc3o7by7ZTHYw604Pu52jjE_So032Ep_v7CH09e7esL7LLj-fv69PLzOQi5xmvaCcanVfQEi6qJgdieCVBNqKkrAChaQUaKHScM9rmXdVoWYJmlS6NFoQfoZc735Tp5wRxVM5Gk1bWA_gpKlpyyRkphfwftOBpKUYT-uIvdOWnkKLdUiznvCx5oo53lAk-xgCdWgfrdJgVJWpbqtqWqm5LTfDzveXUpG-_R-9aTADdARvbw_wPK_Wh_rS8M812mtQq_LrX6PBDpcCyUN-uztXnqy_1m_rtUp3xP6FGvkQ</recordid><startdate>201612</startdate><enddate>201612</enddate><creator>Loh, Z. W. R.</creator><creator>Cheen, M. H. H.</creator><creator>Wee, H. L.</creator><general>Blackwell Publishing Ltd</general><general>Hindawi Limited</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1108-1494</orcidid></search><sort><creationdate>201612</creationdate><title>Humanistic and economic outcomes of pharmacist-provided medication review in the community-dwelling elderly: A systematic review and meta-analysis</title><author>Loh, Z. W. R. ; Cheen, M. H. H. ; Wee, H. L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4643-391f6ba49ed0369b4e0c397e7b68125e6a19eae1ef3321d4f9ba78ea29a8ca603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Community Pharmacy Services - economics</topic><topic>costs</topic><topic>elderly</topic><topic>Health Care Costs</topic><topic>Hospitalization - economics</topic><topic>Humans</topic><topic>Pharmacists</topic><topic>Prescription Drugs - economics</topic><topic>Prescription Drugs - therapeutic use</topic><topic>Quality of Life</topic><topic>systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Loh, Z. W. R.</creatorcontrib><creatorcontrib>Cheen, M. H. H.</creatorcontrib><creatorcontrib>Wee, H. L.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical pharmacy and therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Loh, Z. W. R.</au><au>Cheen, M. H. H.</au><au>Wee, H. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Humanistic and economic outcomes of pharmacist-provided medication review in the community-dwelling elderly: A systematic review and meta-analysis</atitle><jtitle>Journal of clinical pharmacy and therapeutics</jtitle><addtitle>J Clin Pharm Ther</addtitle><date>2016-12</date><risdate>2016</risdate><volume>41</volume><issue>6</issue><spage>621</spage><epage>633</epage><pages>621-633</pages><issn>0269-4727</issn><eissn>1365-2710</eissn><coden>JCPTED</coden><abstract>Summary
What is known and objective
Recent reviews have shown that pharmacist‐provided medication review in the elderly can improve clinical outcomes and reduce medication discrepancies compared with usual care. However, none determined whether these translate to improved humanistic and economic outcomes. This review sought to evaluate the effects of medication review on health‐related quality of life (HRQoL) and healthcare costs in the elderly.
Methods
A systematic search of MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane library for studies published in English from inception to 31 August 2015 was conducted. The review included studies lasting at least 3 months that randomly assigned community‐dwelling participants aged at least 65 years to receive either pharmacist‐provided medication review or usual care. Studies set in nursing homes were excluded.
Results and discussion
The review identified 25 studies that included 15 341 participants and lasted between 3 and 36 months. Twenty and 13 studies reported HRQoL and economic outcomes, respectively. Overall, there was no significant difference in HRQoL and healthcare costs between pharmacist‐provided medication review and usual care. Meta‐analysis of studies that reported the 36‐item Short‐Form Health Survey found significant differences in favour of usual care in the body pain (mean difference: 2·94, 95% CI: 0·54–5·34, P = 0·02) and general health perception (mean difference: 1·83, 95% CI: 0·16–3·50, P = 0·03) domains, whereas there were no significant differences in other domains. Meta‐analysis of the EuroQol‐5D utility (mean difference: −0·01, 95% CI: −0·02–0·01, P = 0·57) and visual analogue scale (mean difference: 0·01, 95% CI: −3·24–3·26, P = 1·00) found no significant differences. Costs of hospitalization, medication and other healthcare resources consumed were similar between groups.
What is new and conclusion
Humanistic and economic outcomes of pharmacist‐provided medication review were largely similar to those of usual care. Further research using more robust methodology is needed to determine whether improved medication management can improve HRQoL and reduce healthcare costs. Careful thought should be given to capturing relevant outcomes that reflect the potential benefits of this intervention.
A systematic search of the literature was conducted to assess the impact of pharmacist‐provided medication review on health‐related quality of life (HRQoL) and healthcare cost in the elderly. The review included 26 articles involving 15 440 participants. The studies had several methodological issues that predisposed them to bias. Current evidence suggests that pharmacist‐provided medication review has similar effects as usual care in terms of its impact on HRQoL and healthcare cost in the elderly.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>27696540</pmid><doi>10.1111/jcpt.12453</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-1108-1494</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of clinical pharmacy and therapeutics, 2016-12, Vol.41 (6), p.621-633 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Community Pharmacy Services - economics costs elderly Health Care Costs Hospitalization - economics Humans Pharmacists Prescription Drugs - economics Prescription Drugs - therapeutic use Quality of Life systematic review |
| title | Humanistic and economic outcomes of pharmacist-provided medication review in the community-dwelling elderly: A systematic review and meta-analysis |
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