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Impact of pharmacist interventions provided in the emergency department on quality use of medicines: a systematic review and meta-analysis

Citation

Atey, TM and Peterson, GM and Salahudeen, MS and Bereznicki, LR and Wimmer, BC, Impact of pharmacist interventions provided in the emergency department on quality use of medicines: a systematic review and meta-analysis, Emergency Medicine Journal pp. 1-8. ISSN 1472-0205 (2022) [Refereed Article]

Copyright Statement

Author(s) (or their employer(s)) 2022.

DOI: doi:10.1136/emermed-2021-211660

Abstract

Background: Pharmacists have an increasing role as part of the emergency department (ED) team. However, the impact of ED-based pharmacy interventions on the quality use of medicines has not been well characterised.

Objective: This systematic review aimed to synthesise evidence from studies examining the impact of interventions provided by pharmacists on the quality use of medicines in adults presenting to ED.

Methods: A systematic literature search was conducted in MEDLINE, EMBASE and CINAHL. Two independent reviewers screened titles/abstracts and reviewed full texts. Studies that compared the impact of interventions provided by pharmacists with usual care in ED and reported medication-related primary outcomes were included. Cochrane Risk of Bias-2 and Newcastle-Ottawa tools were used to assess the risk of bias. Summary estimates were pooled using random-effects meta-analysis, along with sensitivity and sub-group analyses.

Results: Thirty-one studies involving 13 242 participants were included. Pharmacists were predominantly involved in comprehensive medication review, advanced pharmacotherapy assessment, staff and patient education, identification of medication discrepancies and drug-related problems, medication prescribing and co-prescribing, and medication preparation and administration. The activities reduced the number of medication errors by a mean of 0.33 per patient (95% CI -0.42 to -0.23, I2=51%) and the proportion of patients with at least one error by 73% (risk ratio (RR)=0.27, 95% CI 0.19 to 0.40, I2=85.3%). The interventions were also associated with more complete and accurate medication histories, increased appropriateness of prescribed medications by 58% (RR=1.58, 95% CI 1.21 to 2.06, I2=95%) and quicker initiation of time-critical medications.

Conclusion: The evidence indicates improved quality use of medicines when pharmacists are included in ED care teams.

Item Details

Item Type:Refereed Article
Keywords:Emergency department, pharmacists, interventions, quality use of medicines, systematic review, medication errors, outcomes
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacy and pharmacy practice
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health outcomes
UTAS Author:Atey, TM (Mr Tesfay Atey)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
UTAS Author:Salahudeen, MS (Dr Mohammed Salahudeen)
UTAS Author:Bereznicki, LR (Professor Luke Bereznicki)
UTAS Author:Wimmer, BC (Dr Barbara Wimmer)
ID Code:151663
Year Published:2022
Deposited By:Pharmacy
Deposited On:2022-08-02
Last Modified:2022-09-19
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