Could Chinese cardiovascular chronic conditions patients gain benefits from pharmaceutical services? A multilevel meta-analysis

Background The value of pharmaceutical services for Chinese patients with cardiovascular chronic conditions was not recognized. Aim To investigate the comprehensive value of pharmaceutical services in China and find factors influencing patient benefits. Design and setting This was a systematic review with multilevel meta-analysis of 183 randomized control trials focusing on the benefits of pharmaceutical services for patients with cardiovascular chronic conditions in China. Methods English databases (PubMed, EMBASE, the Cochrane Library) and Chinese databases (China National Knowledge Infrastructure, WanFang database) were searched from database inception to March 27, 2023 for studies focusing on the comparation of benefits between pharmaceutical services and usual care. Results Our analysis of 187 studies involving 23,895 patients demonstrated significant benefits of pharmaceutical services, particularly in reducing readmission (OR: 0.32; 95%CI: 0.2 to 0.52; I2=50.12%), mitigating ADR (OR: 0.28; 95%CI: 0.24 to 0.33; I2=18.07%), and improving patient adherence. However, no benefit was observed in terms of mortality rate and the cost of hospitalization and medication and the risk of bias was generally existed among the included studies. Conclusions This study highlights the significant benefits of pharmaceutical services for clinical outcomes and adherence among Chinese patients with cardiovascular chronic conditions. However, the benefits in terms of economic outcomes remain unclear. The influence of population-specific factors, such as disease and age, underscores the need for context-specific and disease-tailored studies to provide precise evidence regarding the advantages of pharmaceutical services. And our findings provide some new ideas for the subsequent research and design, standard formulation and policy implementation.