Pharmacist-Led Chronic Disease Management: A Systematic Review of Effectiveness and Harms Compared With Usual Care

作者：Nancy Greer, Jennifer Bolduc, Eric Geurkink, Thomas S. Rector, Kimberly Olson, Eva Koeller, Roderick MacDonald, Timothy J Wilt · 发表于：Annals of Internal Medicine · 年份：2016 · DOI：10.7326/m15-3058 · 被引用次数：141 · 研究领域：Pharmaceutical Practices and Patient Outcomes、Medication Adherence and Compliance、Diabetes Management and Education

BACKGROUND: Increased involvement of pharmacists in patient care may increase access to health care and improve patient outcomes. PURPOSE: To determine the effectiveness and harms of pharmacist-led chronic disease management for community-dwelling adults. DATA SOURCES: MEDLINE, Cochrane Library, CINAHL, and International Pharmaceutical Abstracts from 1995 through February 2016, and reference lists of systematic reviews and included studies. STUDY SELECTION: 65 patient populations in 63 studies conducted in the United States of any design reported outcomes of pharmacist-led chronic disease management versus a comparator for community-dwelling adults in the United States. Studies set in retail pharmacies were excluded. DATA EXTRACTION: Data extraction done by a single investigator was confirmed by a second investigator; risk of bias was assessed by 2 investigators; and strength of evidence was determined by consensus. DATA SYNTHESIS: Pharmacist-led care was associated with similar numbers of office visits, urgent care or emergency department visits, and hospitalizations (moderate-strength evidence) and medication adherence (low-strength evidence) compared with usual care (typically continuing a prestudy visit schedule). Pharmacist-led care increased the number or dose of medications received and improved study-selected glycemic, blood pressure, and lipid goal attainment (moderate-strength evidence). Mortality and clinical events were similar (low-strength evidence). Evidence on...