Ashkon Ardavani, Ffion Curtis, Ellen Hopwood, Patrick Highton, Priscilla Katapa, Kamlesh Khunti, Thomas J Wilkinson
{"title":"药剂师对慢性肾病的干预效果:一项荟萃分析。","authors":"Ashkon Ardavani, Ffion Curtis, Ellen Hopwood, Patrick Highton, Priscilla Katapa, Kamlesh Khunti, Thomas J Wilkinson","doi":"10.1093/ndt/gfae221","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pharmacists are uniquely placed with their therapeutic knowledge to manage people with chronic kidney disease (CKD). Data is limited regarding the impact of pharmacist interventions on economic, clinical, and humanistic outcomes (ECHO).</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials (RCTs) of interventions with pharmacist input was conducted, which included adults with a diagnosis of CKD, including those with and without kidney replacement therapy. Data was extracted on ECHO: economic (e.g. healthcare-associated costs), clinical (e.g. mortality), and humanistic (e.g. patient satisfaction) outcomes. Where appropriate, a random-effects model meta-analysis generated a pooled estimate of effect. A direction of effect plot was used to summarize the overall effects for clinical outcome domains.</p><p><strong>Results: </strong>32 RCTs reported a total of 10 economic, 211 clinical, and 18 humanistic outcomes. Pharmacist interventions resulted in statistically significant improvements in systolic blood pressure and hemoglobin levels, but not in diastolic blood pressure, estimated glomerular filtration rate, creatinine, and low-density lipoprotein cholesterol levels. Mixed findings were reported for clinical and economic outcomes, whilst pharmacist interventions resulted in an improvement in humanistic outcomes such as patient satisfaction and patient knowledge.</p><p><strong>Conclusion: </strong>Findings showed pharmacist interventions had mixed results for various outcomes. Future studies should be more robustly designed and take into consideration the role of the pharmacist in prescribing and deprescribing, the findings of which will help inform research and clinical practice.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of pharmacist interventions in chronic kidney disease: a meta-analysis.\",\"authors\":\"Ashkon Ardavani, Ffion Curtis, Ellen Hopwood, Patrick Highton, Priscilla Katapa, Kamlesh Khunti, Thomas J Wilkinson\",\"doi\":\"10.1093/ndt/gfae221\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pharmacists are uniquely placed with their therapeutic knowledge to manage people with chronic kidney disease (CKD). Data is limited regarding the impact of pharmacist interventions on economic, clinical, and humanistic outcomes (ECHO).</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials (RCTs) of interventions with pharmacist input was conducted, which included adults with a diagnosis of CKD, including those with and without kidney replacement therapy. Data was extracted on ECHO: economic (e.g. healthcare-associated costs), clinical (e.g. mortality), and humanistic (e.g. patient satisfaction) outcomes. Where appropriate, a random-effects model meta-analysis generated a pooled estimate of effect. A direction of effect plot was used to summarize the overall effects for clinical outcome domains.</p><p><strong>Results: </strong>32 RCTs reported a total of 10 economic, 211 clinical, and 18 humanistic outcomes. Pharmacist interventions resulted in statistically significant improvements in systolic blood pressure and hemoglobin levels, but not in diastolic blood pressure, estimated glomerular filtration rate, creatinine, and low-density lipoprotein cholesterol levels. Mixed findings were reported for clinical and economic outcomes, whilst pharmacist interventions resulted in an improvement in humanistic outcomes such as patient satisfaction and patient knowledge.</p><p><strong>Conclusion: </strong>Findings showed pharmacist interventions had mixed results for various outcomes. Future studies should be more robustly designed and take into consideration the role of the pharmacist in prescribing and deprescribing, the findings of which will help inform research and clinical practice.</p>\",\"PeriodicalId\":19078,\"journal\":{\"name\":\"Nephrology Dialysis Transplantation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2024-10-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nephrology Dialysis Transplantation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ndt/gfae221\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"TRANSPLANTATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nephrology Dialysis Transplantation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ndt/gfae221","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"TRANSPLANTATION","Score":null,"Total":0}
Effect of pharmacist interventions in chronic kidney disease: a meta-analysis.
Background: Pharmacists are uniquely placed with their therapeutic knowledge to manage people with chronic kidney disease (CKD). Data is limited regarding the impact of pharmacist interventions on economic, clinical, and humanistic outcomes (ECHO).
Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) of interventions with pharmacist input was conducted, which included adults with a diagnosis of CKD, including those with and without kidney replacement therapy. Data was extracted on ECHO: economic (e.g. healthcare-associated costs), clinical (e.g. mortality), and humanistic (e.g. patient satisfaction) outcomes. Where appropriate, a random-effects model meta-analysis generated a pooled estimate of effect. A direction of effect plot was used to summarize the overall effects for clinical outcome domains.
Results: 32 RCTs reported a total of 10 economic, 211 clinical, and 18 humanistic outcomes. Pharmacist interventions resulted in statistically significant improvements in systolic blood pressure and hemoglobin levels, but not in diastolic blood pressure, estimated glomerular filtration rate, creatinine, and low-density lipoprotein cholesterol levels. Mixed findings were reported for clinical and economic outcomes, whilst pharmacist interventions resulted in an improvement in humanistic outcomes such as patient satisfaction and patient knowledge.
Conclusion: Findings showed pharmacist interventions had mixed results for various outcomes. Future studies should be more robustly designed and take into consideration the role of the pharmacist in prescribing and deprescribing, the findings of which will help inform research and clinical practice.
期刊介绍:
Nephrology Dialysis Transplantation (ndt) is the leading nephrology journal in Europe and renowned worldwide, devoted to original clinical and laboratory research in nephrology, dialysis and transplantation. ndt is an official journal of the [ERA-EDTA](http://www.era-edta.org/) (European Renal Association-European Dialysis and Transplant Association). Published monthly, the journal provides an essential resource for researchers and clinicians throughout the world. All research articles in this journal have undergone peer review.
Print ISSN: 0931-0509.