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Br J Clin Pharmacol. 2019 Aug 29. doi: 10.1111/bcp.14101. [Epub ahead of print]

Pharmacist services in nursing home: A systematic review and meta-analysis.

Author information

1
School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia.
2
Gerentology Laboratory, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
3
School of Pharmacy, Taylor's University Lakeside Campus, Jalan Taylors, 47500, Subang Jaya, Selangor, Malaysia.
4
Center of Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.

Abstract

AIMS:

Pharmacists have been contributing to the care of residents in nursing homes and play a significant role in ensuring quality use of medicine. However, the changing role of pharmacist in nursing homes and their impact on residents is relatively unknown.

METHODS:

Six electronic databases were searched from inception until November 2018 for articles published in English examining the services offered by pharmacists in nursing homes. Studies were included if it examined the impact of interventions by pharmacists to improve the quality use of medicine in nursing homes.

RESULTS:

Fifty-two studies (30,376 residents) were included in the current review. Thirteen studies were randomised controlled studies, while the remainder were either pre-post, retrospective or case-control studies which pharmacists provided services such as clinical medication review in collaboration with other healthcare professionals as well as staff education. Pooled analysis found that pharmacist-led services reduced the mean number of falls (-0.50; 95%CI: -0.79 to -0.21) among residents in nursing home. Mixed results were noted on the impact of pharmacists' services on mortality, hospitalization and admission rates among residents. The potential financial savings of such services have not been formally evaluated by any studies thus far. The strength of evidence was moderate for the outcomes of mortality and number of fallers.

CONCLUSION:

Pharmacists contribute substantially to patient care in nursing homes, ensuring quality use of medication, resulting in reduced fall rates. Further studies with rigorous design are needed to measure the impact of pharmacist services on the economic benefits and other patient health outcomes.

KEYWORDS:

inappropriate medication; medication review; nursing home; pharmacist; polypharmacy; systematic review

PMID:
31465121
DOI:
10.1111/bcp.14101

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