Study shows that pharmacists have positive effect on patient care
Pharmacist intervention lowers adverse drug events
Pharmacists have a positive effect on reducing adverse drug events (ADEs), improving health outcomes, and improving medication adherence and patient knowledge about their medicines, according to a new study.1
"I'm a PharmD and clinician by trade, and what I find striking is the clinical outcomes were so significant," says Marie Chisholm-Burns, PharmD, MPH, FCCP, FASHP, professor and head of the department of pharmacy practice and science at the University of Arizona College of Pharmacy in Tucson, AZ.
"We did a systematic review and meta-analyses, looking at 55,000 citations of published articles," she adds. "By the time we went through our process and criteria we had almost 300 studies in the analysis."
The research team reviewed studies between 1922 and 2009, searching more than a dozen databases.
Investigators looked for studies in which pharmacists were involved in direct patient care, and they analyzed these for themes.
"We had a multidisciplinary team of physicians, nurses, pharmacists, an attorney, and an economist involved in the study," Chisholm-Burns says.
The team found that patients with diabetes had better outcomes when pharmacists were directly involved in their care, Chisholm-Burns says.
"Pharmacists' direct care helped to reduce ADEs, prevent rehospitalization, reduce length of stay in the hospital, and prevent medication errors," she says.
Quality of life factors also were improved with pharmacist involvement.
"Especially patients' general health was significantly improved with pharmacists involved in care," Chisholm-Burns says.
In a meta-analysis of hemoglobin A1c, LDL cholesterol, and blood pressure, investigators found that there was a significant difference with pharmacist care.
"Patients had better control of their diabetes, more improved blood pressure when pharmacists were involved in direct patient care of their activities," Chisholm-Burns says.
"It was striking that our involvement did make a difference in these studies," she adds. "These were consistent and statistically significant findings."
For example, the study found that patients who had a pharmacist involved in their care were 47% less likely to experience an ADE. Also, close to 90% of studies that looked at pharmacists' involvement in managing hemoglobin A1c found positive results. Likewise, 84% of the studies that looked at blood pressure management, and 82% of studies involving cholesterol management showed positive results regarding pharmacist involvement in care.1
The study was funded by the American Society of Health-System Pharmacists (ASHP) and the ASHP Foundation in Bethesda, MD. ASHP's goal is to advance practice models optimizing the role of pharmacists as members of the health care team.
"ASHP is trying to get the word out to everybody," Chisholm-Burns says.
The research, some of which is still being published, will support the pharmacy practice model initiative (PPMI), which brings together some thought leaders around the country to develop practice models supporting the use of pharmacists as direct patient care providers.
While it's great that ASHP is spreading the word throughout the health care industry that pharmacists can be valued members of the clinical team, it's even more important that the American public learn about this role for pharmacists, Chisholm-Burns notes.
"We should expand our circle a little more," she adds. "My goal is to get this word out to the American people because they're the consumers and they need to know about how to access pharmacist care."
In the United States, which still ranks low in many public health indicators, it's especially important that pharmacists are involved in any future models of clinical care, she says.
"We should want to do a better job of improving our health in this country," Chisholm-Burns says. "I think pharmacists could be a critical piece in this puzzle given the right circumstances."
Eventually, the American people might demand to have pharmacists involved in their care, she adds.
"Maybe having pharmacists involved in direct patient care would be the solution to help improve health care in the United States," she says.
Reference
- Chisholm-Burns MA, Lee JK, Spivey CA, et al. U.S. pharmacists' effect as team members on patient care: systematic review and meta-analyses. Med Care. 2010; [epub ahead of print].
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