title: Economic effects of pharmacists on health outcomes in the United States: A systematic review.
abstract: OBJECTIVE
  A systematic review examining the economic effects of pharmacist-provided direct patient care on health outcomes in the United States was conducted.
  
  
  METHODS
  A comprehensive literature search was conducted using 13 academic and medical databases. Studies were included in the analysis if they described pharmacist-provided direct patient care, used comparison groups, evaluated economic outcomes, and were conducted in the United States. Outcome results were categorized as (1) favorable, indicating significant improvement as a result of pharmacists' interventions or services, (2) not favorable, indicating significant improvement as a result of nonpharmacist care, (3) mixed, having favorable results on one measure of a study variable but not favorable results or no effect on another, (4) having no effect, indicating no significant difference between pharmacists' interventions or services and the comparison, or (5) unclear, indicating the outcome could not be determined based on presented data.
  
  
  RESULTS
  Of the 56,573 citations considered, a total of 126 studies met the criteria for inclusion in this systematic review. Results favoring pharmacist-provided care were found in 20 studies (15.9%), mixed results were seen in 53 studies (42.1%), no effect was found in 6 studies (4.8%), and unclear results were found in 47 studies (37.3%).
  
  
  CONCLUSIONS
  A majority of studies examining the economic effects of pharmacist-provided direct patient care in the United States were limited by their partial cost analyses, study design, and other analysis considerations. A majority of the 20 studies that found positive economic benefits examined pharmacists' interventions involving technical methods or multimodal approaches.
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona (UA), Tucson, AZ 85721, USA. chisholm@pharmacy.arizona.edu
authors.forename: Marie A
authors.initials: MA
authors.lastname: Chisholm-Burns
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Graff Zivin
authors.forename: Jeannie Kim
authors.initials: JK
authors.lastname: Lee
authors.forename: Christina A
authors.initials: CA
authors.lastname: Spivey
authors.forename: Marion
authors.initials: M
authors.lastname: Slack
authors.forename: Richard N
authors.initials: RN
authors.lastname: Herrier
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hall-Lipsy
authors.forename: Ivo
authors.initials: I
authors.lastname: Abraham
authors.forename: John
authors.initials: J
authors.lastname: Palmer
mesh_terms: D006801:Humans; D017063:Outcome Assessment, Health Care; D005791:Patient Care / Q000191:economics*; D010593:Pharmaceutical Services / Q000191:economics / Q000458:organization & administration*; D010595:Pharmacists / Q000191:economics / Q000458:organization & administration*; D024382:Professional Role; D014481:United States