A systematic review of pharmaceutical care interventions in patients with rheumatoid arthritis.

Abstract

Objectives: This systematic review aimed to describe the work process of pharmaceutical care provided to patients with rheumatoid arthritis (RA).

Methods: A systematic review was undertaken based on a search of six databases. The protocol was registered in PROSPERO (CRD42020133705). The inclusion criteria were randomized clinical trials (RCTs) with pharmaceutical care as an intervention in patients previously diagnosed with RA. Two investigators independently selected the studies, extracted data, and assessed their methodological quality. The RoB 2 tool was used to evaluate the quality of the studies. A narrative synthesis of results was provided.

Key findings: A total of 3078 titles were found in the initial search, but only six RCTs, with a total of 337 patients, met the established inclusion criteria. These RCTs had some limitations, and only one had a low risk of bias. In most studies (66.6%), the service performed as an intervention had low complexity, was focused only on health education and did not have an individualized care plan for each patient. Telephone interviews or counseling sessions prevailed. The most evaluated outcome was medication adherence. When the intervention was remote and of shorter duration, the improvement in medication adherence was up to 8% (P < .05), whereas when a pharmacotherapeutic follow-up service was provided, this improvement reached 59% (P = .002). Pharmaceutical intervention was also associated with a significant improvement in beliefs about medications, patient satisfaction, reduced drug-related problems, and the cost of treatment.

Conclusion: The pharmaceutical care processes should be adjusted to consider the complexity of treatment and patient profiles to produce tailored care plans.