{"title":"药剂师干预精神分裂症和双相情感障碍：系统回顾和荟萃分析。","authors":"Juliana Pimenta Netto, Amanda Veiga Barbosa, Brígida Dias Fernandes, Inajara Rotta, Patricia Melo Aguiar","doi":"10.1016/j.sapharm.2025.08.008","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia and bipolar affective disorder (BAD) are chronic mental disorders that cause severe disability and represent a significant burden of disease. Pharmacists play a critical role in enhancing patient care and improving health outcomes. However, no systematic review with meta-analysis on pharmacist interventions in these populations has been published.</p><p><strong>Objective: </strong>To evaluate the efficacy of pharmacist interventions in improving health outcomes for patients with schizophrenia or BAD.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed, Cochrane Central, Embase, and Google Scholar until March 2024. Randomized controlled trials (RCTs) assessing pharmacist interventions on any health outcome (except pharmacoeconomic) in patients with schizophrenia or BAD were included. Two independent investigators conducted the study selection, data extraction, and risk of bias assessment (Rob 2 tool). Meta-analyses were conducted using random-effect models in the RStudio software.</p><p><strong>Results: </strong>Seven RCTs, published between 2017 and 2024 in middle-income countries, were included. Four studies focused on schizophrenia, three on BAD. The majority (40-60 %) of participants were female, aged 35-40. Six RCTs implemented health education as a pharmacist intervention, with medication adherence and quality of life being the primary outcomes assessed. Meta-analyses were conducted for quality of life outcomes in schizophrenia and BAD, and demonstrated that pharmacist interventions significantly improved overall scores and all domains of the WHOQOL-BREF instrument (physical, psychological, social relationships, and environmental), with a low certainty of evidence. In addition, clinical and process outcomes showed a significant improvement after the pharmacist intervention. However, all outcomes were classified with a high risk of bias according to the RoB 2 tool, mainly due to issues with outcome measurement.</p><p><strong>Conclusion: </strong>Pharmacist interventions may significantly impact the health outcomes of patients with schizophrenia or BAD, but more high-quality RCTs are needed to solidify these findings.</p>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pharmacist interventions in schizophrenia and bipolar affective disorder: A systematic review and meta-analysis.\",\"authors\":\"Juliana Pimenta Netto, Amanda Veiga Barbosa, Brígida Dias Fernandes, Inajara Rotta, Patricia Melo Aguiar\",\"doi\":\"10.1016/j.sapharm.2025.08.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Schizophrenia and bipolar affective disorder (BAD) are chronic mental disorders that cause severe disability and represent a significant burden of disease. Pharmacists play a critical role in enhancing patient care and improving health outcomes. However, no systematic review with meta-analysis on pharmacist interventions in these populations has been published.</p><p><strong>Objective: </strong>To evaluate the efficacy of pharmacist interventions in improving health outcomes for patients with schizophrenia or BAD.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed, Cochrane Central, Embase, and Google Scholar until March 2024. Randomized controlled trials (RCTs) assessing pharmacist interventions on any health outcome (except pharmacoeconomic) in patients with schizophrenia or BAD were included. Two independent investigators conducted the study selection, data extraction, and risk of bias assessment (Rob 2 tool). Meta-analyses were conducted using random-effect models in the RStudio software.</p><p><strong>Results: </strong>Seven RCTs, published between 2017 and 2024 in middle-income countries, were included. Four studies focused on schizophrenia, three on BAD. The majority (40-60 %) of participants were female, aged 35-40. Six RCTs implemented health education as a pharmacist intervention, with medication adherence and quality of life being the primary outcomes assessed. Meta-analyses were conducted for quality of life outcomes in schizophrenia and BAD, and demonstrated that pharmacist interventions significantly improved overall scores and all domains of the WHOQOL-BREF instrument (physical, psychological, social relationships, and environmental), with a low certainty of evidence. In addition, clinical and process outcomes showed a significant improvement after the pharmacist intervention. However, all outcomes were classified with a high risk of bias according to the RoB 2 tool, mainly due to issues with outcome measurement.</p><p><strong>Conclusion: </strong>Pharmacist interventions may significantly impact the health outcomes of patients with schizophrenia or BAD, but more high-quality RCTs are needed to solidify these findings.</p>\",\"PeriodicalId\":48126,\"journal\":{\"name\":\"Research in Social & Administrative Pharmacy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-08-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Research in Social & Administrative Pharmacy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.sapharm.2025.08.008\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Research in Social & Administrative Pharmacy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.sapharm.2025.08.008","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Pharmacist interventions in schizophrenia and bipolar affective disorder: A systematic review and meta-analysis.
Background: Schizophrenia and bipolar affective disorder (BAD) are chronic mental disorders that cause severe disability and represent a significant burden of disease. Pharmacists play a critical role in enhancing patient care and improving health outcomes. However, no systematic review with meta-analysis on pharmacist interventions in these populations has been published.
Objective: To evaluate the efficacy of pharmacist interventions in improving health outcomes for patients with schizophrenia or BAD.
Methods: A literature search was conducted in PubMed, Cochrane Central, Embase, and Google Scholar until March 2024. Randomized controlled trials (RCTs) assessing pharmacist interventions on any health outcome (except pharmacoeconomic) in patients with schizophrenia or BAD were included. Two independent investigators conducted the study selection, data extraction, and risk of bias assessment (Rob 2 tool). Meta-analyses were conducted using random-effect models in the RStudio software.
Results: Seven RCTs, published between 2017 and 2024 in middle-income countries, were included. Four studies focused on schizophrenia, three on BAD. The majority (40-60 %) of participants were female, aged 35-40. Six RCTs implemented health education as a pharmacist intervention, with medication adherence and quality of life being the primary outcomes assessed. Meta-analyses were conducted for quality of life outcomes in schizophrenia and BAD, and demonstrated that pharmacist interventions significantly improved overall scores and all domains of the WHOQOL-BREF instrument (physical, psychological, social relationships, and environmental), with a low certainty of evidence. In addition, clinical and process outcomes showed a significant improvement after the pharmacist intervention. However, all outcomes were classified with a high risk of bias according to the RoB 2 tool, mainly due to issues with outcome measurement.
Conclusion: Pharmacist interventions may significantly impact the health outcomes of patients with schizophrenia or BAD, but more high-quality RCTs are needed to solidify these findings.
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.
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