Association of Pharmacist Interventions with Adverse Drug Events and
Potential Adverse Drug Events
Abstract
Background: Adverse drug events (ADEs) are a frequent cause of
injury in patients. Our aim was to assess pharmacist interventions and
their association with ADEs and potential adverse drug events (PADE).
Methods: The search criteria: a published RCT, evidence of a
pharmacist intervention, a comparison control group, and measurement of
ADEs or PADEs. The information sources included MEDLINE, Embase, and two
other databases through September 19, 2022. The risk of bias was
assessed using the Cochrane tool for RCTs. A random-effects model for
pooled studies was employed Results: Fifteen references meeting
inclusion criteria were discovered. For ADEs, the pooled results showed
a statistically significant benefit of pharmacist intervention in
comparison to the control group (RR = 0.86; [95% CI 0.80-0.94); P =
0.0005. The heterogeneity was insignificant (P = 0.72; I
2 = 0%). Patients receiving a pharmacist intervention
were 14% less likely for ADE than those who did not receive a
pharmacist intervention. The estimated number of patients needed to
prevent one ADE across all patient locations was 33. For PADEs, the
pooled results did not show a statistically significant benefit for
pharmacist intervention in comparison to the control group (RR = 0.79;
[95% CI 0.47 – 1.32]; P =0.37.There was substantial heterogeneity
in the pooled studies (P = 0.01; I 2 = 77%). However,
there was a statistically significant subgroup difference (P = 0.005)
for the intervention type. Conclusions: To our knowledge, this
is the first systematic review and meta-analysis of RCTs seeking to
understand the association of pharmacist interventions with ADEs and
PADEs. The risk of having an ADE is reduced by a seventh for patients
receiving a pharmacist care intervention versus no such intervention.
This fraction could be higher for certain high-risk patients. The
estimated number of patients needed to be followed across all patient
locations to prevent one preventable ADE across all patient locations is
33. Also, a subgroup analysis of pharmacist intervention focus suggests
that further research is necessary to fully understand the impact of TOC
pharmacist intervention on PADEs. If validated, these findings have
potential to significantly reduce drug-related morbidity and related
healthcare costs.