Table 1 Literature Characteristics
NO. | Author (year) country | Sample description | Pharmacist interventions | Primary outcomes | Effect |
|---|---|---|---|---|---|
1 | Bill et al [6] (1992) US | From 1984 to 1987, patients admitted to the hospitals, 432 admissions on four general medicine services over 12 months | Provide a brief guidebook, a booklet on cost strategies and common expenses, detailed temporary bills, and information on the number of days hospitalized and the usual hospitalization costs | Hospitalization days, diagnosis-related group adjustment costs, direct standardization charges | Positive |
2 | Maryanne [7] (1992) US | Not reported | Change dosage and content of prescriptions; discontinue use of prescriptions | avoided costs | Positive |
3 | Carter et al [8] (1997) US | Adult patients with primary hypertension in any ethnic group in a Christian medical clinic, 25 in the intervention group and 26 in the control group | Visit patients every 3–5 weeks and get drug supplement; measure blood pressure and pulse; inquire about adverse drug reactions and improve adherence to treatment at each follow-up; write a complete progress record; evaluate the patient’s current medical treatment and understanding of lifestyle changes; record all patient data and send a copy to the patient’s physicians for review; pharmacists and physicians involved at that time contacted and provide services for patients who needed to change medications; standardize patient education, distribute brochures, visual materials, and verbal instructions | Blood pressure, visits, medication costs | Positive |
4 | GL et al [9] (1997) US | Patients who received parenteral antibiotics from January to March 1994 at the Portland Hospital in the US, 141 in the intervention group and 111 in the control group | Provide patient-specific, antibiotic-related advice to the attending physician (by a team of infectious disease researchers and clinical pharmacists) | Reuse of antibiotics, mortality, per capita antibiotic costs | No effect |
5 | Gums et al [10] (1999) US | In the adult patient with uncontrolled dyslipidemia defined by the 2009 Canadian Dyslipidemia Guidelines, 43 were in the intervention group and 44 in the control group. | Determine the best intravenous antibiotics; advise on antibiotic treatment and monitoring | Hospitalization time, average hospitalization days, hospitalization costs, patient mortality | Positive |
6 | Dager et al [11] (2000) US | A 400-bed teaching hospital, patients older than 18 years old, who received warfarin for the first time, the 60 patients hospitalized in 1992 were the control group, and 60 patients hospitalized in 1995 were intervention groups. | Review the patient’s medication history; provide written consultations daily on the medical charts of patients with warfarin dosing recommendations | Hospitalization days, average INR at the time of discharge from the INR | Positive |
7 | Canales et al [12] (2001) US | From May to December 1997, any psychiatric patient admitted to the Austin National Hospital with acute psychotic symptoms, 45 in the intervention group and 48 in the control group | Participate in treatment group meetings; perform baseline assessments and weekly observations; provide medication recommendations; obtain medication history; review drug administration daily records; monitor adverse drug reactions; conduct medication education classes; consult patients before they leave the hospital | Average medical treatment cost per patient during hospitalization | Positive |
8 | Brook et al [13] (2003) Netherlands | From April 2000 to April 2001, patients who went to pharmacies to purchase antidepressant drugs, 64 in the intervention group and 71 in the control group | Introduce drugs and drug efficacy to patients and discuss ways of drug use; provide videos related to pharmaceutical education and patient counsels | The number of positive drug attitudes | Positive |
9 | Bolas et al [14] (2004) UK | The hospitalized patients in the Antrim district hospital were 81 in the intervention group and 81 in the control group | Prepare accurate drug records after full review of current drug use; drug counseling; provide medication record forms to inform patients on how to take medication; provide medications detailing changes in drug treatment; release letter (general practitioner faxed to patient on the day of discharge community pharmacist); provide helpline for medicines | Average mismatch rate between discharge prescription and household medication, average error rate of drug treatment knowledge | Positive |
10 | Carter et al [15] (2009) US | Men and women aged over 21 in 6 clinics diagnosed as essential hypertension, taking 0 to 3 compression medicines, 192 intervention groups and 210 control groups | make drug therapy recommendations to physicians based on national guidelines | Blood pressure, blood pressure control rate | Positive |
11 | Wong et al [16] (2010) Singapore | From 2006 to 2007, patients in the general medical and surgical departments of a 1200-bed nursing teaching hospital in Singapore who initially started taking warfarin for deep vein thrombosis, pulmonary embolism or atrial fibrillation, intervention group 144 and control group 26 | Support the commencement and titration of warfarin anticoagulant services; provide written counseling and discuss the case with the doctor; recommend daily warfarin’s dose; check and monitor patients’ International Normalization Ratio until they are ready for discharge; recommend discharge doses and appointment dates for anticoagulation clinics | Hospitalization days, international standardized ratio, average number of days discharged | Positive |
12 | Hammad et al [17] (2011) Jordan | From March to November 2009, patient enrolled in the family medical clinic of Jordan University Hospital, 110 in the intervention group and 89 in the control group | Provide a 30-min consultation before meeting with a physician | Triglycerides, high-density lipoprotein cholesterol, blood sugar, Blood pressure | Positive |
13 | Shen et al [18] (2011) China | Between July 2009 and April 2010, inpatients in two separate respiratory wards at three teaching hospitals, 178 in the control group and 176 in the intervention group | communicate with physicians; make recommendations on treatment options | Hospitalization costs, antibiotic costs, hospitalization days | Positive |
14 | Mousavi et al [19] (2012) Iran | Patients who had at least one significant risk factor or at least two related risk factors in the kidney ward of the Iranian Khomeini Hospital Complex for 6 months, 375 in the intervention group and 236 in the control group | escort physicians in the ward and gives suggestions | Appropriate and inappropriate stress ulcer prophylaxis management per patient cost | Positive |
15 | Shah et al [20] (2012) US | Between 2010 and 2011, diabetes patients over 18 years old in a public hospital and health care system, 31 in the intervention group and 21 in the control group | Consult on routine care and post-discharge diabetes drug dosage, side effects and clinical benefits; concurrent diabetes mellitus symptoms, hypoglycemia, healthy eating, exercise and reduced use guidelines emotional education; follow-up after discharge | Cholesterol, lipoprotein, Blood pressure, glycated hemoglobin | Positive |
16 | Zhang et al [3] (2012) China | The pediatric patients with neurological diseases, respiratory diseases or digestive diseases in the Second Hospital of HuaXi, Chengdu, China, 76 in the intervention group and 74 in the control group | Answer questions from doctors and nurses; provide treatment advice; prevent medication errors | Hospitalization days, medical cost per patient, readmission rate | Mixed |
17 | Cies, Varlotta [21] (2013) US | From January 2007 to August 2008 in St. Christopher’s Children’s Hospital, 29 in the intervention group and 22 in the control group | Specialized clinical pharmacists monitor and adjust drug dosing; monitor initial and subsequent tobramycin levels | Total cost, hospitalization cost, dose adjustment cost, average hospitalization days | Positive |
18 | Ho et al [22] (2013) UK | From January 1, 2004 to March 31, 2007, patients admitted to the Royal Hospital of Colombia had 333 interventions and 1228 patients in the control group | The presence or absence of one or more clinical pharmacy notes recorded in the inpatient record during the ICU admission | Complete cohort mortality | Positive |
19 | Chilipko, Norwood [23] (2014) US | From January 1, 2009 to January 1, 2011 in a community teaching hospital, patients are over 18 years old and receive warfarin for at least 3 days, 125 in the intervention group and 108 in the control group | Provide anticoagulation management services for warfarin; daily monitor warfarin dosage | In-hospital average treatment time, hospitalization period average number of days for achieving INR goals, total incidence of bleeding, average albumin | Mixed |
20 | Grimes et al [24] (2014) UK | Between July 2010 and May 2011 Adult patients at the Tallaght Hospital in Dublin, Ireland, 112 in the intervention group and 121 in the control group | Medication reconciliation and prescription exams; understand the inpatient history of medication | Errors in medication, changes in cumulative drug adaptability index before admission to hospital and after discharge | Positive |
21 | Joost et al [25] (2014) Germany | From August 2008 to July 2010 at the Erlangen University Hospital, patients who were able to visit repeatedly for outpatients with kidney disease and hypertension, 35 in the intervention group and 39 in the control group | Provide additional inpatient and outpatient pharmaceutical care; counsel by a specialized clinical pharmacist | Percentage of days of correct dosage, pc adhesion rate | Positive |
22 | Tan et al [26] (2014) Australia | From December 2011 to January 2013, in two general practice clinics in Melbourne, Australia, 62 patients with one or more risk factors for medication-related problems, sample size 62 people | Provide face-to-face consultations; interview in private clinics for about 30–60 min; resolve issues related to identifying drugs at home | Patient’s rate of adherence to their medication, health score | Positive |
23 | Vervacke, Lorent, Motte [27] (2014) Belgian | From September 2009 to March 2012, in a Belgian urban academic hospital who aged 75 or older with a history of venous thromboembolism or cancer, 336 before the intervention, 431 after the intervention | Provide education for specific physicians and nurses; disseminate teaching tools to summarize guidelines and reminders for venous thromboembolism prevention | Number of patients at risk of venous thromboembolism | Positive |
24 | Xin et al [4] (2014) China | From January to December 2013, in Zhejiang Province Tongde Hospital who is less than 18 years old, diagnosed as type 2 diabetes, 420 before the intervention, 429 after the intervention | A full-time experienced pharmacist served in the team | Hemoglobin, lipoproteins, triglycerides, Blood pressure, hospitalization days, medication costs | Positive |
25 | Zhang et al [28] (2014) China | From 2011 to 2012, inpatients undergoing cleansing or decontamination operations in the Department of Urology, 174 before intervention and 196 after intervention | Monitor drug information and make medical records in real time through the hospital information system; establish standards for the administration of preventive antibiotic prescriptions through hospital management | Drug costs, antibiotic prevention delay days | Positive |
26 | Campo, Roberts, Cooter [29] (2015) Australia | University of South Australia’s Higher Education Hospital Flinders Medical Center admitted to the respiratory ward in July 2010, 31 patients in the intervention group and 30 in the control group | Measure 4 whole-day glycemic profiles 24 h per phase (Non-diabetic patients with chronic obstructive pulmonary disease); daily test 4 whole-day glycemic profiles (patients with chronic obstructive pulmonary disease); blood glucose levels are at 700 h, 1200 h, 1700 h (before meals) and 2100 h for routine monitoring | Achieve daily minimum blood glucose monitoring level, cross-time blood glucose level test | Positive |
27 | Delpeuch et al [30] (2015) French | Department of Hematology/Oncology, Affiliated Hospital of Medical School, Patient with solid tumor (excluding lung cancer), sample size 552 | Comprehensive drug review (chemotherapy, supportive care and outpatient treatment) | Drug related issues | Mixed |
28 | Obarcanin et al [31] (2015) Yugoslavia and Germany | Two paediatric clinics in the Krefeld region of Germany and Sarajevo, Bosnia and Herzegovina, 39 in the intervention group and 26 in the control group | Provide access to pharmaceutical services monthly and record clinical data during visits; patients in the intervention group measured at least 4 times daily blood glucose; assess drug-related needs and identify problems; develop an individualized pharmaceutical care plan for each patient; pharmacists discuss the drug care plan with physicians | Glycated hemoglobin | Positive |
29 | Wolf et al [2] (2015) UK | From September 2012 to December 2013, 269 mental patients were sent to the psychiatric department, 131 in the intervention group and 134 in the control group | Provide detailed medication reconciliation at admission and medication reviews at discharge and 3 months after discharge; two clinical pharmacists follow each week during hospitalization | Change in drug fitness index, number of medication-related issues | Positive |
30 | Burnett et al [32] (2016) US | All patients who received heparin-induced thrombocytopenia per-intervention (10/1/2009–9/ 30/2010) and post-intervention (10/1/2010–9/30/2011) had 167 patients before the intervention, 104 people after the intervention | The pharmacy-driven 4 T score (4 T pretest probability score) intervention | Calculated 4 T score, number of patients with major bleeding, number of patients with thrombotic events, average cost per patient | Positive |
31 | Gallagher et al [33] (2016) UK | From June 2011 to June 2012, hospitalized patients in an 810-bed teaching hospital in Ireland, 361 people in the intervention groups and 376 people in the control group | Provide medication reconciliation, deployment of clinical decision support software; formulation of a pharmaceutical health plan | Total cost, adverse drug reactions | Mixed |
32 | Khalil V et al [34] (2016) Australia | Inpatients in general hospitals in a hospital in Australia, 56 in the intervention group and 54 in the control group | Pharmacist medication guidance | Medication errors, the severity of prescribing errors | Positive |
33 | Phatak et al [35] (2016) US | From November 2012 to June 2013, patients discharged from the 894-bed academic medical center or western memorial hospital of the Northwest Memorial Hospital in Chicago, Illinois, 137 in the intervention group and 141 in the control group | Face-to-face medication reconciliation; a patient-specific pharmaceutical care plan; discharge counseling; post discharge phones call on days 3, 14, and 30 to provide education and assess study endpoints | High-risk average, number of days admitted to hospital/emergency, drug-related readmissions, general hospital admissions | Positive |
34 | Watersl et al [36] (2017) US | A hospital in the US had been discharged from the emergency department and had been discharged, and was later found to be a positive bacterial pathogen in the blood culture. 138 were in the intervention group and 107 in the control group | Provide advice on proper antibiotic selection, dosage, route, and duration; evaluate the efficacy of excretion antibiotics and intervene when pathogen-antibiotic mismatches are found; reduce workload of physicians’ in emergency departments; improve antimicrobial management experience in the culture process | Proportion of patients receiving appropriate antibiotic treatment, rate of admission or readmission within 90 days, the number of 90-day cases of illness | Positive |
35 | Sloeserwij et al [37] (2019) Netherlands | From January 2013 to May 2015, 11,928 high-risk patients were included | 10 specially trained non-dispensing pharmacists took integral responsibility for the pharmaceutical care. They provide a wide range of medication management services at the patient level (e.g. clinical drug review) and the level of practice (e.g. quality improvement projects). | the number of medication-related hospitalisations | Possitive |
36 | Schumacher et al [38] (2018) US | From November 2009 toAugust 2010, Clinical pharmacists visited and intervened 111 patients with chronic heart failure. | Clinical pharmacists improve hospitalization rates and 30-day readmission rates for heart failure through more frequent follow-up and improved access to care. Clinical Spaces have been established for clinical pharmacists including patient visit rooms and independent provider schedules. But the need for other chronic comorbidity quickly became apparent, requiring expanded services and the role of clinical pharmacists within months of the establishment of the practice. | readmission rates | Possitive |
37 | Korcegez et al [39] (2017) Northern Cyprus | From October 2013 to July 2015,152 patients were treated in the diabetes clinic of a public hospital in gazimagus, northern Cyprus. The patients were divided into two groups: intervention group (75 cases) and usual care group (77 cases). | Each patient scheduled a meeting with the study clinical pharmacist on the same day as the doctor’s appointment. The pharmacist interviewed the patient in an independent office next to the doctor’s office. The intervention group conducted 5 consecutive visits with a pharmacist every 3 months and reviewed the medication and treatment plan. | change in A1c | Possitive |
38 | Domingues et al [40] (2017) Spain | From April 2013 to November 2014, the study population included 42 patients receiving treatment from the third hospital pharmacy outpatient department and receiving antiretroviral therapy. | Drug treatment was followed up using the dader method. Interviews were conducted every 2 months. During each interview, the patient’s medication, health problems, and modifiable cardiovascular risk factors were assessed. Direct drug care interventions to patients when lifestyle changes or improved treatment compliance are required. If treatment needs to be evaluated, the doctor receives a written report. | changes in cardiovascular risk | Possitive |
39 | Ospina et al [41] (2017) Colombia | From November 2011to June 2014, 92 patients were randomly divided into intervention group (43) and control group (49). | The pharmacist calls every week until the end of the study. During these calls, the pharmacist did the following: (a) conducting clinical assessments, assessing changes in mood, behavior, regular eating and sleep patterns, language and thinking; (b) emphasizing the importance of patient education and the identification and management of prodromal symptoms; (c) to explain the correct use of bipolar drugs; (d) promoting treatment compliance; and (e) promoting healthy eating and lifestyle habits. | hospitalizations and emergency service consultations, unscheduled outpatient visits, clinical evaluation of depression and mania | Mixed |
40 | Javaid et al [42] (2019) Pakistan | From August 2016to June 2017, there were 52 and 83 patients in the control and intervention arm, respectively | Pharmacological interventions involve working with doctors to identify drug-related issues, drug interactions, dose, frequency changes, and treatment transitions, whereas non- pharmacological interventions involve diet, lifestyle, and behavioral counseling. | glycemic (HbA1c), lipid controls. | Possitive |
41 | Shao et al [43] (2017) China | After strict screening, 120 patients were randomly divided into two groups. And one hundred ninety-nine patients completed the study | Interviews included face-to-face interviews (once every other month) and telephone follow-up (every month) until the end of the study. During the interview, the pharmacist discussed about their medication compliance, self-monitoring of blood sugar control, and exercise; explained side effects and possible drug interactions; and reminded them to see the doctor next time. | FBG, HbA1c, TC, the target attainment rates of HbA1c, BP | Possitive |
42 | Juanes et al [44] (2018) US | From January 2012 and February 2013, patients were allocated in a 1:1 ratio of potential drug-related problems (intervention group) or administered as standard care (control group). | review the following aspects of the patient’s medication: (a) the indications of each drug are related to the patient’s condition; (b) the suitability, dose, plan, and treatment time of each drug are related to the patient’s age and / or clinical status (renal or liver function). In addition, therapeutic drug monitoring was carried out for drugs with narrow treatment range.. Follow up. Assess the effectiveness and safety of treatment based on standard clinical practice and objective patient data from clinical records. | drug-related negative outcomes | Possitive |