Abstract：
BACKGROUND: Adverse drug events (ADEs) are a frequent cause of injury in patients. Our aim was to assess whether pharmacist interventions compared with no pharmacist intervention results in reduced ADEs and potential adverse drug events (PADEs).
METHODS: We searched MEDLINE, Embase, and two other databases through September 19, 2022 for any RCT assessing the effect of a pharmacist intervention compared with no pharmacist intervention and reporting on ADEs or PADEs. The risk of bias was assessed using the Cochrane tool for RCTs. A random-effects model was used to pool summary results from individual RCTs.
RESULTS: Fifteen RCTs met the inclusion criteria. The pooled results showed a statistically significant reduction in ADE associated with pharmacist intervention compared with no pharmacist intervention (RR = 0.86; [95% CI 0.80-0.94]; p = 0.0005) but not for PADEs (RR = 0.79; [95% CI 0.47-1.32]; p = 0.37). The heterogeneity was insignificant (I2 = 0%) for ADEs and substantial (I2 = 77%) for PADEs. Patients receiving a pharmacist intervention were 14% less likely for ADE than those who did not receive a pharmacist intervention. The estimated number of patients needed to prevent one ADE across all patient locations was 33.
CONCLUSIONS: To our knowledge, this is the first systematic review and meta-analysis of RCTs seeking to understand the association of pharmacist interventions with ADEs and PADEs. The risk of having an ADE is reduced by a seventh for patients receiving a pharmacist care intervention versus no such intervention. The estimated number of patients needed to be followed across all patient locations to prevent one preventable ADE across all patient locations is 33.
METHODS: We searched MEDLINE, Embase, and two other databases through September 19, 2022 for any RCT assessing the effect of a pharmacist intervention compared with no pharmacist intervention and reporting on ADEs or PADEs. The risk of bias was assessed using the Cochrane tool for RCTs. A random-effects model was used to pool summary results from individual RCTs.
RESULTS: Fifteen RCTs met the inclusion criteria. The pooled results showed a statistically significant reduction in ADE associated with pharmacist intervention compared with no pharmacist intervention (RR = 0.86; [95% CI 0.80-0.94]; p = 0.0005) but not for PADEs (RR = 0.79; [95% CI 0.47-1.32]; p = 0.37). The heterogeneity was insignificant (I2 = 0%) for ADEs and substantial (I2 = 77%) for PADEs. Patients receiving a pharmacist intervention were 14% less likely for ADE than those who did not receive a pharmacist intervention. The estimated number of patients needed to prevent one ADE across all patient locations was 33.
CONCLUSIONS: To our knowledge, this is the first systematic review and meta-analysis of RCTs seeking to understand the association of pharmacist interventions with ADEs and PADEs. The risk of having an ADE is reduced by a seventh for patients receiving a pharmacist care intervention versus no such intervention. The estimated number of patients needed to be followed across all patient locations to prevent one preventable ADE across all patient locations is 33.
摘要：
背景：不良药物事件（ADE）是患者受伤的常见原因。我们的目的是评估与无药剂师干预相比，药剂师干预是否会减少ADE和潜在的药物不良事件（PADE）。
方法：我们搜索了MEDLINE，Embase,以及截至2022年9月19日的其他两个数据库，用于评估药剂师干预与无药剂师干预和报告ADE或PADE的效果的任何RCT。使用CochraneRCT工具评估偏倚风险。随机效应模型用于汇集来自各个RCT的汇总结果。
结果：15项随机对照试验符合纳入标准。汇总结果显示，与没有药剂师干预相比，与药剂师干预相关的ADE有统计学意义的显著降低(RR=0.86;[95%CI0.80-0.94];p=0.0005)，但与PADE无关(RR=0.79;[95%CI0.47-1.32];p=0.37)。ADE的异质性不显著(I2=0%)，PADEs的异质性显著(I2=77%)。接受药剂师干预的患者与未接受药剂师干预的患者相比，ADE的可能性降低了14％。在所有患者位置预防一种ADE所需的患者人数估计为33。
结论：据我们所知，这是对旨在了解药剂师干预与ADE和PADE之间关联的RCT的首次系统评价和荟萃分析.与没有这种干预相比，接受药剂师护理干预的患者患ADE的风险降低了七分之一。需要在所有患者位置跟踪以防止在所有患者位置的一个可预防的ADE的患者的估计数量是33。
方法：我们搜索了MEDLINE，Embase,以及截至2022年9月19日的其他两个数据库，用于评估药剂师干预与无药剂师干预和报告ADE或PADE的效果的任何RCT。使用CochraneRCT工具评估偏倚风险。随机效应模型用于汇集来自各个RCT的汇总结果。
结果：15项随机对照试验符合纳入标准。汇总结果显示，与没有药剂师干预相比，与药剂师干预相关的ADE有统计学意义的显著降低(RR=0.86;[95%CI0.80-0.94];p=0.0005)，但与PADE无关(RR=0.79;[95%CI0.47-1.32];p=0.37)。ADE的异质性不显著(I2=0%)，PADEs的异质性显著(I2=77%)。接受药剂师干预的患者与未接受药剂师干预的患者相比，ADE的可能性降低了14％。在所有患者位置预防一种ADE所需的患者人数估计为33。
结论：据我们所知，这是对旨在了解药剂师干预与ADE和PADE之间关联的RCT的首次系统评价和荟萃分析.与没有这种干预相比，接受药剂师护理干预的患者患ADE的风险降低了七分之一。需要在所有患者位置跟踪以防止在所有患者位置的一个可预防的ADE的患者的估计数量是33。
