Effects of hospital pharmacist interventions on health outcomes in older polymedicated inpatients: a scoping review

Abstract

Aim Do patients receiving polypharmacy benefit from interventions by hospital pharmacists, individually or as part of a multidisciplinary team? Findings Some beneficial effects were found of pharmacist interventions in 15 of 26 studies, specifically on hospital readmission, visits to the emergency department and healthcare costs. Message Evidence in favour of hospital pharmacist interventions in polymedicated older patients is scarce. Well-designed studies, with clearly defined interventions, outcomes and follow-up times should be conducted in the future to define the role of pharmacists in the geriatric team.

Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (The IMMENSE study) – a randomized controlled trial

“…Our results are in line with two other RCTs performed simultaneously in Scandinavia [ 22 , 33 ]. Both studies failed to show a significant reduction in readmissions or ED visits after 12 months, despite applying multifaceted interdisciplinary interventions with pharmacists as integrated team members as recommended [ 16 , 18 , 19 ]. One possible explanation for the lack of effect of the IMMENSE intervention, may be that the intervention elements were not patient-focused enough.…”

“…However, studies investigating the effects of clinical pharmacist services on patient outcomes such as readmissions and emergency department (ED) visits have shown conflicting results [ 16 , 17 ]. Systematic reviews suggest that multifaceted interdisciplinary interventions with pharmacists as integrated team members may be necessary for interventions to impact patient outcomes [ 16 , 18 , 19 ].…”

Efficacy of a Pharmacist Team Clinical Medication Review in Older Adults: A Prospective and Retrospective Observational Study

“…Intervention by pharmacists as part of a multidisciplinary geriatric team is generally considered to provide greater benefits than intervention by pharmacists alone. 21) In addition, reducing polypharmacy in patients with multiple comorbidities has been shown to be more effective when collaborating with specialists such as cardiologists and neurologists. 22) To correct polypharmacy more widely, it is necessary to constitute a multidisciplinary polypharmacy team in collaboration with physicians, nurses, and other professionals.…”

The role of pharmacists in geriatric teams: the time is now

“…One of the strategies that seem to have more favourable results is the creation of interdisciplinary teams with professionals trained in the management of pharmacotherapy in elderly patients [1]. In this sense, there is evidence of improved outcomes when one of the professionals is the pharmacist [2,3]. Second, there is no doubt that new technologies help us a lot in our daily work, a well as the revision of existing inappropriate prescription criteria, such as STOPP-START, but the complexity of these patients requires individualized attention; already, it has been seen, for example, that clinical practice guidelines with the best available evidence are useless.…”