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Evidence of clinical and economic impact of pharmacist interventions related to antimicrobials in the hospital setting
- Source :
- European journal of clinical microbiologyinfectious diseases : official publication of the European Society of Clinical Microbiology. 37(5)
- Publication Year :
- 2017
-
Abstract
- The purpose of this paper was to review the literature regarding the clinical and economic impact of pharmacist interventions (PIs) related to antimicrobials in the hospital setting. A PubMed literature search from January 2003 to March 2016 was conducted using the terms pharmacist* or clinical pharmacist* combined with antimicrobial* or antibiotic* or anti-infective*. Comparative studies that assessed the clinical and/or economic impact of PIs on antimicrobials in the hospital setting were reviewed. Outcomes were classified as: treatment-related outcomes (TROs), clinical outcomes (COs), cost and microbiological outcomes (MOs). Acceptance of pharmacist recommendations by physicians was collected. PIs were grouped into patient-specific recommendations (PSRs), policy, and education. Studies' risk of bias was analyzed using Cochrane's tool. Twenty-three studies were evaluated. All of them had high risk of bias. The design in most cases was uncontrolled before and after. PSRs were included in every study; five also included policy and four education. Significant impact of PI was found in 14 of the 18 studies (77.8%) that evaluated costs, 15 of the 20 studies (75.0%) that assessed TROs, 12 of the 22 studies (54.5%) that analyzed COs, and one of the two studies (50.0%) that evaluated MOs. None of the studies found significant negative impact of PIs. It could not be concluded that adding other strategies to PSRs would improve results. Acceptance of recommendations varied from 70 to 97.5%. Pharmacists improve TROs and COs, and decrease costs. Additional research with a lower risk of bias is unlikely to change this conclusion. Future research should focus on identifying the most efficient interventions.
- Subjects :
- Microbiology (medical)
medicine.medical_specialty
Cost-Benefit Analysis
MEDLINE
Pharmacist
Psychological intervention
Lower risk
Pharmacists
030226 pharmacology & pharmacy
03 medical and health sciences
0302 clinical medicine
Professional Role
Anti-Infective Agents
Health care
Outcome Assessment, Health Care
Medicine
Humans
Public Health Surveillance
030212 general & internal medicine
Cost–benefit analysis
business.industry
General Medicine
Health Care Costs
Models, Theoretical
Hospitals
Clinical pharmacy
Hospitalization
Infectious Diseases
Family medicine
Meta-analysis
business
Subjects
Details
- ISSN :
- 14354373
- Volume :
- 37
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- European journal of clinical microbiologyinfectious diseases : official publication of the European Society of Clinical Microbiology
- Accession number :
- edsair.doi.dedup.....057c448a4f41715dd0eefa9f0a210309