title: US pharmacists' effect as team members on patient care: systematic review and meta-analyses.
abstract: BACKGROUND
  One approach postulated to improve the provision of health care is effective utilization of team-based care including pharmacists.
  
  
  OBJECTIVE
  The objective of this study was to conduct a comprehensive systematic review with focused meta-analyses to examine the effects of pharmacist-provided direct patient care on therapeutic, safety, and humanistic outcomes.
  
  
  METHODS
  The following databases were searched from inception to January 2009: NLM PubMed; Ovid/MEDLINE; ABI/INFORM; Health Business Fulltext Elite; Academic Search Complete; International Pharmaceutical Abstracts; PsycINFO; Cochrane Database of Systematic Reviews; National Guideline Clearinghouse; Database of Abstracts of Reviews of Effects; ClinicalTrials.gov; LexisNexis Academic Universe; and Google Scholar. Studies selected included those reporting pharmacist-provided care, comparison groups, and patient-related outcomes. Of these, 56,573 citations were considered. Data were extracted by multidisciplinary study review teams. Variables examined included study characteristics, pharmacists' interventions/services, patient characteristics, and study outcomes. Data for meta-analyses were extracted from randomized controlled trials meeting meta-analysis criteria.
  
  
  RESULTS
  A total of 298 studies were included. Favorable results were found in therapeutic and safety outcomes, and meta-analyses conducted for hemoglobin A1c, LDL cholesterol, blood pressure, and adverse drug events were significant (P < 0.05), favoring pharmacists' direct patient care over comparative services. Results for humanistic outcomes were favorable with variability. Medication adherence, patient knowledge, and quality of life-general health meta-analyses were significant (P < 0.05), favoring pharmacists' direct patient care.
  
  
  CONCLUSIONS
  Pharmacist-provided direct patient care has favorable effects across various patient outcomes, health care settings, and disease states. Incorporating pharmacists as health care team members in direct patient care is a viable solution to help improve US health care.
authors: Department of Pharmacy Practice and Science, The University of Arizona College of Pharmacy, Tucson, AZ 85721, USA. chisholm@pharmacy.arizona.edu
authors: Marie A
authors: MA
authors: Chisholm-Burns
authors: Jeannie
authors: J
authors: Kim Lee
authors: Christina A
authors: CA
authors: Spivey
authors: Marion
authors: M
authors: Slack
authors: Richard N
authors: RN
authors: Herrier
authors: Elizabeth
authors: E
authors: Hall-Lipsy
authors: Joshua
authors: J
authors: Graff Zivin
authors: Ivo
authors: I
authors: Abraham
authors: John
authors: J
authors: Palmer
authors: Jennifer R
authors: JR
authors: Martin
authors: Sandra S
authors: SS
authors: Kramer
authors: Timothy
authors: T
authors: Wunz
mesh_terms: D003157:Community Pharmacy Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration* / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000458:organization & administration; D010595:Pharmacists / Q000458:organization & administration* / Q000706:statistics & numerical data; D024382:Professional Role; D011369:Professional-Patient Relations; D014481:United States; D016903:Drug Monitoring