Effectiveness of pharmacist-led medication review in chronic pain management: systematic review and meta-analysis.
OBJECTIVE
To evaluate the effectiveness of pharmacist-led medication review in chronic pain management.


METHODS
Six electronic databases (Medline, Embase, PsycInfo, CINHAL, CENTRAL, International Pharmaceutical Abstracts) reference lists of retrieved articles and relevant websites were searched for randomized controlled trials published in the English language involving adults with chronic pain. Studies were included if one of the intervention arms had received pharmacist-led medication review independently or as part of a multidisciplinary intervention. Risk of bias was assessed for all the included studies.


RESULTS
The search strategy yielded 583 unique articles including 5 randomized controlled trials. Compared with control, meta-analysis showed that participants in the intervention group had: a 0.8-point reduction in pain intensity on a 0 to 10 numerical rating scale at 3 months [95% confidence interval (CI), -1.28 to -0.36] and a 0.7-point reduction (95% CI, -1.19 to -0.20) at 6 months; a 4.84 point (95% CI, -7.38 to -2.29) and -3.82 point (95% CI, -6.49 to -1.14) improvement in physical functioning on a 0- to 68-point function subscale of Western Ontario and McMaster Universities Osteoarthritis Index at 3 and 6 months, respectively; and a significant improvement in patient satisfaction equivalent to a "small to moderate effect."


CONCLUSIONS
Pharmacist-led medication review reduces pain intensity and improves physical functioning and patient satisfaction. However, the clinical significance of these findings remain uncertain due to small effect size and nature of reported data within clinical trials that limits recommendation of wider clinical role of pharmacist in chronic pain management.
*Discipline of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia †School of Healthcare ∥Center for Epidemiology & Biostatistics, University of Leeds §Institute of Health and Well Being, Leeds Metropolitan University, Leeds ‡Bradford School of Pharmacy, University of Bradford, Bradford, United Kingdom.
Muhammad A
MA
Hadi
David P
DP
Alldred
Michelle
M
Briggs
Theresa
T
Munyombwe
S José
SJ
Closs
D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy*; D006801:Humans; D059408:Pain Management / Q000379:methods*; D017060:Patient Satisfaction; D010595:Pharmacists; D016032:Randomized Controlled Trials as Topic
D000700:Analgesics