Association of Pharmacist Interventions With Adverse Drug Events and Potential Adverse Drug Events.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacoepidemiology and Drug Safety Pub Date : 2024-07-01 DOI:10.1002/pds.5853

W N Kelly, M J Ho, T Smith, K Bullers, D W Bates, A Kumar

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Abstract

Background: Adverse drug events (ADEs) are a frequent cause of injury in patients. Our aim was to assess whether pharmacist interventions compared with no pharmacist intervention results in reduced ADEs and potential adverse drug events (PADEs).

Methods: We searched MEDLINE, Embase, and two other databases through September 19, 2022 for any RCT assessing the effect of a pharmacist intervention compared with no pharmacist intervention and reporting on ADEs or PADEs. The risk of bias was assessed using the Cochrane tool for RCTs. A random-effects model was used to pool summary results from individual RCTs.

Results: Fifteen RCTs met the inclusion criteria. The pooled results showed a statistically significant reduction in ADE associated with pharmacist intervention compared with no pharmacist intervention (RR = 0.86; [95% CI 0.80-0.94]; p = 0.0005) but not for PADEs (RR = 0.79; [95% CI 0.47-1.32]; p = 0.37). The heterogeneity was insignificant (I² = 0%) for ADEs and substantial (I² = 77%) for PADEs. Patients receiving a pharmacist intervention were 14% less likely for ADE than those who did not receive a pharmacist intervention. The estimated number of patients needed to prevent one ADE across all patient locations was 33.

Conclusions: To our knowledge, this is the first systematic review and meta-analysis of RCTs seeking to understand the association of pharmacist interventions with ADEs and PADEs. The risk of having an ADE is reduced by a seventh for patients receiving a pharmacist care intervention versus no such intervention. The estimated number of patients needed to be followed across all patient locations to prevent one preventable ADE across all patient locations is 33.

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药剂师干预与药物不良事件和潜在药物不良事件的关联。

背景：药物不良事件（ADEs）是导致患者受伤的一个常见原因。我们的目的是评估药剂师干预与无药剂师干预相比是否会减少药物不良事件（ADEs）和潜在药物不良事件（PADEs）：截至 2022 年 9 月 19 日，我们在 MEDLINE、Embase 和其他两个数据库中检索了所有评估药师干预与无药师干预效果的 RCT，并报告了 ADE 或 PADE。采用 Cochrane RCT 工具评估偏倚风险。采用随机效应模型汇总各 RCT 的汇总结果：结果：15 项 RCT 符合纳入标准。汇总结果显示，与无药剂师干预相比，药剂师干预可在统计学上显著减少 ADE（RR = 0.86；[95% CI 0.80-0.94]；p = 0.0005），但 PADEs（RR = 0.79；[95% CI 0.47-1.32]；p = 0.37）则没有显著减少。ADEs的异质性不显著（I2 = 0%），PADEs的异质性显著（I2 = 77%）。接受药剂师干预的患者发生 ADE 的几率比未接受药剂师干预的患者低 14%。据估计，在所有患者地点预防一次 ADE 所需的患者人数为 33.结论：据我们所知，这是首次对 RCT 进行系统回顾和荟萃分析，旨在了解药剂师干预与 ADE 和 PADE 之间的关系。接受药剂师护理干预与不接受药剂师干预相比，患者发生 ADE 的风险降低了七分之一。据估计，在所有患者所在地预防一次可预防的 ADE 所需的随访患者人数为 33 人。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.