Impact of pharmacist-led interventions on economic, clinical, and humanistic outcomes (ECHO) in patients admitted to emergency departments: A systematic review of randomized controlled trials

IF 3.4 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Research in Social & Administrative Pharmacy Pub Date : 2026-02-01 Epub Date: 2025-10-21 DOI:10.1016/j.sapharm.2025.10.007

Emre Kara , Betul Okuyan , Cansu Goncuoglu , Kutay Demirkan , Shusen Sun

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引用次数: 0

Abstract

Background

The role of pharmacists in emergency departments (EDs) has undergone a significant transformation globally, expanding beyond traditional responsibilities to include various clinical activities that promise to enhance patient outcomes. However, the full potential of these interventions, particularly from economic, clinical, and humanistic (ECHO) perspectives, remains to be systematically explored. The aim of this study was to evaluate the impact of pharmacist-led interventions on ECHO among patients admitted to the ED.

Methods

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted in PubMed, MEDLINE, and International Pharmaceutical Abstracts, focusing on randomized controlled trials (RCTs) published in English that involved pharmacist interventions in EDs. Data were extracted on study design, pharmacist interventions, and patient outcomes. Cochrane risk-of-bias tool for randomized trials (RoB 2.0) was used.

Results

Twelve RCTs that met the inclusion criteria were identified. The studies were conducted predominantly in tertiary care settings in various countries. The most common interventions performed by pharmacists included medication reconciliation, obtaining medication histories, and patient education. The review showed that pharmacist interventions tend to improve medication safety and patient satisfaction but varied significantly in their execution and reported outcomes. No studies comprehensively analyzed economic outcomes, and only a few addressed humanistic outcomes.

Conclusions

Pharmacy-led services improved clinical outcomes, however there was lack of studies showing the economic and humanistic outcomes of these services. The need for standardized protocols and further research to establish their broader impacts should be considered. The findings support the continued integration and expansion of pharmacist roles in emergency care, which could influence global policy and practice in healthcare systems.

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药剂师主导的干预措施对急诊科入院患者的经济、临床和人文预后（ECHO）的影响：随机对照试验的系统综述

在全球范围内，急诊科（ed）药剂师的角色经历了重大转变，超越了传统的职责，包括各种有望提高患者预后的临床活动。然而，这些干预措施的全部潜力，特别是从经济、临床和人文（ECHO）的角度来看，仍有待系统地探索。本研究的目的是评估药剂师主导的干预措施对ed住院患者的ECHO的影响。方法本系统评价按照系统评价和荟萃分析（PRISMA）指南的首选报告项目进行。我们在PubMed、MEDLINE和国际药学文摘中进行了检索，重点是随机对照试验（RCTs），这些试验用英文发表，涉及药剂师对急诊科的干预。我们提取了研究设计、药剂师干预和患者预后方面的数据。采用Cochrane随机试验风险偏倚工具（RoB 2.0）。结果共纳入12项符合纳入标准的随机对照试验。这些研究主要是在各国的三级保健机构进行的。药剂师最常见的干预措施包括药物和解、获取用药史和患者教育。回顾显示，药师干预倾向于提高用药安全性和患者满意度，但在执行和报告结果方面差异显着。没有研究全面分析经济成果，只有少数研究涉及人文成果。结论以药房为主导的服务改善了临床结果，但缺乏研究显示这些服务的经济和人文效果。应考虑是否需要标准化的协议和进一步研究以确定其更广泛的影响。研究结果支持药剂师在急诊护理中的持续整合和扩大作用，这可能影响全球卫生保健系统的政策和实践。

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

Research in Social & Administrative Pharmacy PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.20

自引率

10.30%

发文量

225

审稿时长

47 days

期刊介绍： Research in Social and Administrative Pharmacy (RSAP) is a quarterly publication featuring original scientific reports and comprehensive review articles in the social and administrative pharmaceutical sciences. Topics of interest include outcomes evaluation of products, programs, or services; pharmacoepidemiology; medication adherence; direct-to-consumer advertising of prescription medications; disease state management; health systems reform; drug marketing; medication distribution systems such as e-prescribing; web-based pharmaceutical/medical services; drug commerce and re-importation; and health professions workforce issues.