Abstract
Objectives
Pharmacists’ care has an essential role in multidisciplinary teams in charge of chronic
patients. However, data available on the clinical outcomes of these activities appear
inconclusive. This study aimed to systematically investigate the effect of multidisciplinary
teams that include coordinated pharmaceutical care on clinical outcomes.
Design
Systematic review and meta-analysis. Relevant studies identified from MEDLINE, Cochrane,
Web of Science, Scopus and CINAHL databases were analyzed. The search included randomized
clinical trials published in 2000-2018. Included studies were all published studies
in English that compared the effectiveness of multidisciplinary teams including pharmacist
care to usual care. Meta-analysis was carried out using a random effects model, and
subgroup analysis was conducted to determine the sources of heterogeneity.
Setting and Participants
29 studies involving 4186 adult patients were included.
Measures
Follow-up time varied from 30 to 180 days. The most common primary endpoint was the
frequency of hospitalizations or readmissions, followed by variation in clinical parameter
variables related to quality of prescription, treatment adherence and costs.
Results
Twelve (41.3%) of the included studies scored low risk of bias according to the AMSTAR-2
scale, the remaining 17 (58.7%) being classified as intermediate risk. The intervention
of a multidisciplinary team reduced the probability of readmission by 32% [odds ratio
(OR) 0.74, 95% confidence interval (CI) 0.62-0.89]. Six of the 29 (20.7%) studies
included met the inclusion criteria of the meta-analysis on quality-of-life outcomes.
The intervention of the multidisciplinary team represented a significant increase
in patients’ quality of life (OR 0.58, 95% CI 0.47-0.69). Analysis of heterogeneity
showed a significant difference between the studies. No evidence of publication bias
was identified.
Conclusions and Implications
Multidisciplinary programs that include pharmaceutical care reduce the risk of visiting
hospitals and improve patients’ quality of life. This review supports the importance
of the pharmacists as part of multidisciplinary teams.
Keywords
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Article info
Publication history
Published online: July 03, 2021
Footnotes
The authors declare no conflicts of interest.
Identification
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