US pharmacists' effect as team members on patient care: systematic review and meta-analyses

Med Care. 2010 Oct;48(10):923-33. doi: 10.1097/MLR.0b013e3181e57962.


Background: One approach postulated to improve the provision of health care is effective utilization of team-based care including pharmacists.

Objective: The objective of this study was to conduct a comprehensive systematic review with focused meta-analyses to examine the effects of pharmacist-provided direct patient care on therapeutic, safety, and humanistic outcomes.

Methods: The following databases were searched from inception to January 2009: NLM PubMed; Ovid/MEDLINE; ABI/INFORM; Health Business Fulltext Elite; Academic Search Complete; International Pharmaceutical Abstracts; PsycINFO; Cochrane Database of Systematic Reviews; National Guideline Clearinghouse; Database of Abstracts of Reviews of Effects;; LexisNexis Academic Universe; and Google Scholar. Studies selected included those reporting pharmacist-provided care, comparison groups, and patient-related outcomes. Of these, 56,573 citations were considered. Data were extracted by multidisciplinary study review teams. Variables examined included study characteristics, pharmacists' interventions/services, patient characteristics, and study outcomes. Data for meta-analyses were extracted from randomized controlled trials meeting meta-analysis criteria.

Results: A total of 298 studies were included. Favorable results were found in therapeutic and safety outcomes, and meta-analyses conducted for hemoglobin A1c, LDL cholesterol, blood pressure, and adverse drug events were significant (P < 0.05), favoring pharmacists' direct patient care over comparative services. Results for humanistic outcomes were favorable with variability. Medication adherence, patient knowledge, and quality of life-general health meta-analyses were significant (P < 0.05), favoring pharmacists' direct patient care.

Conclusions: Pharmacist-provided direct patient care has favorable effects across various patient outcomes, health care settings, and disease states. Incorporating pharmacists as health care team members in direct patient care is a viable solution to help improve US health care.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Community Pharmacy Services / organization & administration*
  • Community Pharmacy Services / statistics & numerical data
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Medication Adherence / statistics & numerical data
  • Patient Care Team / organization & administration*
  • Patient Care Team / statistics & numerical data
  • Patient Education as Topic / statistics & numerical data*
  • Patient-Centered Care / organization & administration
  • Pharmacists / organization & administration*
  • Pharmacists / statistics & numerical data
  • Professional Role
  • Professional-Patient Relations*
  • United States