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Economic evaluations of clinical pharmacist interventions on hospital inpatients: a systematic review of recent literature

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Abstract

Background Clinical and cost-effectiveness evidence are needed to justify the existence or extension of routine clinical pharmacy services in hospital settings. Previous reviews have indicated that clinical pharmacist interventions are likely to have a positive economic impact on hospital budgets but highlighted issues relating to the quality of studies. Aim of the review The primary aim of this review was to feature economic evaluations of clinical pharmacy services which targeted hospital inpatients. The review focused on the current cost-effectiveness status of different services, in addition to evaluating the quality of individual studies. Results of this systematic review were compared with cost-effectiveness and quality related findings of reviews which considered earlier time frames and alternative settings. Methods A systematic review of the literature included a review of the following databases: Academic Search Complete, Cochrane Library, EconLit, Embase Elsevier, NHS Economic Evaluation Database and PubMed. Only studies with an economic assessment of a clinical pharmacy service provided in a hospital setting were included. Data relating to the cost-effectiveness was extracted from eligible studies. Methodologies employed and overall quality of the studies was also reviewed. A grading system was applied to determine the quality of studies. Consolidated Health Economic Evaluation Reporting Standards statement was employed to determine which aspects of a high quality health economic study were employed. Results Twenty studies were deemed eligible for inclusion. Overall, pharmacist interventions had a positive impact on hospital budgets. Only three studies (15 %) were deemed to be “good-quality” studies. No ‘novel’clinical pharmacist intervention was identified during the course of this review. Conclusions Clinical pharmacy interventions continue to provide cost savings. However, the standard of studies published has stagnated or even deteriorated in comparison with those included in previous reviews. Utilisation of published guidelines at initial stages of future studies may help improve the overall quality of studies.

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Acknowledgments

The authors gratefully acknowledge the help of Professor John Browne and the UCC Graduate Studies Office for providing the module entitled, ‘Systematic Reviews for the Health Sciences.’ which notably helped with the development of this systematic review.

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None.

Conflicts of interest

The authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Pharmaceutical Care Research Group, School of Pharmacy, Cavanagh Pharmacy Building, University College Cork, Cork, Ireland

    James Gallagher, Suzanne McCarthy & Stephen Byrne

Authors
  1. James Gallagher
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  2. Suzanne McCarthy
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  3. Stephen Byrne
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Corresponding author

Correspondence to James Gallagher.

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Appendix 1

Appendix 1

See Table 3.

Table 3 Description of studies eligible for inclusion in this review
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Gallagher, J., McCarthy, S. & Byrne, S. Economic evaluations of clinical pharmacist interventions on hospital inpatients: a systematic review of recent literature. Int J Clin Pharm 36, 1101–1114 (2014). https://doi.org/10.1007/s11096-014-0008-9

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