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Table 4 Summary of Findings table

From: The effectiveness and cost of integrating pharmacists within general practice to optimize prescribing and health outcomes in primary care patients with polypharmacy: a systematic review

The effectiveness and cost of integrating pharmacists within general practice to optimize prescribing and health outcomes in primary care patients with polypharmacy

Patients or population: Patients over the age of 65 on five or more medications

Settings: Primary care

Intervention: Pharmacist integration to optimise medications and improve patient outcomes

Comparison: Usual care

Outcomes

Impact

Number of

participants

(Studies)

Certainty of the evidence (GRADE)

Potentially inappropriate prescribing

Ten studies favoured pharmacist integration, eight of which demonstrated signficant changes in favour of the pharmacist integration group

1486 participants

(10 studies)

⊕⊕⊕Ɵa

Moderate

Number of medications

Mean difference -0.80 [-1.17, -0.43]. Direction of effect of four of the seven studies favoured pharmacist integration in reducing the number of medications prescribed. Confidence intervals for three studies included zero

1176 participants

(7 studies)

⊕⊕⊕Ɵa

Moderate

Health-related quality of life

Unclear effect, the direction of results could not be determined due to the heterogeneity in reported results

4535 participants

(15 studies)

⊕ƟƟƟa, b, c

Very low

Adverse drug events

Unclear effect, pharmacist integration tended to reduce the risk of ADEs, two studies reported significant results and two studies did not

409 participants

(4 studies)

⊕⊕ƟƟa, c

Low

Mortality

No clear effect on mortality

327 participants

(2 studies)

⊕⊕ƟƟd

Low

  1. Text highlighted in bold indicate main headings
  2. GRADE Working Group grades of evidence
  3. High = This research provides a very good indication of the likely effect. The likelihood that the effect will be substantially different is low
  4. Moderate = This research provides a good indication of the likely effect. The likelihood that the effect will be substantially different is moderate
  5. Low = This research provides some indication of the likely effect. However, the likelihood that it will be substantially different is high
  6. Very low = This research does not provide a reliable indication of the likely effect. The likelihood that the effect will be substantially different is very high
  7. a downgrade by one level due to serious concerns relating to risk of bias
  8. b downgrade by one level due to serious concerns relating to inconsistency of results
  9. c downgrade by one level due to serious concerns relating to imprecision of results
  10. d downgrade by two levels due to very serious concerns relating to imprecision of results
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BMC Primary Care

ISSN: 2731-4553

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