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dc.contributor.authorDawoud, Dalia M
dc.contributor.authorSmyth, Maria
dc.contributor.authorAshe, Joanna
dc.contributor.authorStrong, Thomas
dc.contributor.authorWonderling, David
dc.contributor.authorHill, Jennifer
dc.contributor.authorVaria, Mihir
dc.contributor.authorDyer, Philip
dc.contributor.authorBion, Julian
dc.date.accessioned2018-12-17T12:45:44Z
dc.date.available2018-12-17T12:45:44Z
dc.date.issued2018-10-19
dc.identifier.citationDawoud , D M , Smyth , M , Ashe , J , Strong , T , Wonderling , D , Hill , J , Varia , M , Dyer , P & Bion , J 2018 , ' Effectiveness and cost effectiveness of pharmacist input at the ward level: a systematic review and meta-analysis ' , Research in Social and Administrative Pharmacy . https://doi.org/10.1016/j.sapharm.2018.10.006
dc.identifier.issn1551-7411
dc.identifier.otherORCID: /0000-0002-2105-1937/work/62751303
dc.identifier.urihttp://hdl.handle.net/2299/20857
dc.description.abstractBackground Pharmacists play important role in ensuring timely care delivery at the ward level. The optimal level of pharmacist input, however, is not clearly defined. Objective To systematically review the evidence that assessed the outcomes of ward pharmacist input for people admitted with acute or emergent illness. Methods The protocol and search strategies were developed with input from clinicians. Medline, EMBASE, Centre for Reviews and Dissemination, The Cochrane Library, NHS Economic Evaluations, Health Technology Assessment and Health Economic Evaluations databases were searched. Inclusion criteria specified the population as adults and young people (age >16 years) who are admitted to hospital with suspected or confirmed acute or emergent illness. Only randomised controlled trials (RCTs) published in English were eligible for inclusion in the effectiveness review. Economic studies were limited to full economic evaluations and comparative cost analysis. Included studies were quality-assessed. Data were extracted, summarised. and meta-analysed, where appropriate. Results Eighteen RCTs and 7 economic studies were included. The RCTs were from USA (n=3), Sweden (n=2), Belgium (n=2), China (n=2), Australia (n=2), Denmark (n=2), Northern Ireland, Norway, Canada, UK and Netherlands. The economic studies were from UK (n=2), Sweden (n=2), Belgium and Netherlands. The results showed that regular pharmacist input was most cost effective. It reduced length-of-stay (mean= -1.74 days [95% CI: -2.76, -0.72], and increased patient and/or carer satisfaction (Relative Risk (RR) =1.49 [1.09, 2.03] at discharge). At £20,000 per quality-adjusted life-year (QALY)-gained cost-effectiveness threshold, it was either cost-saving or cost-effective (Incremental Cost Effectiveness Ratio (ICER) =£632/ QALY-gained). No evidence was found for 7-day pharmacist presence. Conclusions Pharmacist inclusion in the ward multidisciplinary team improves patient safety and satisfaction and is cost-effective when regularly provided throughout the ward stay. Research is needed to determine whether the provision of 7-day service is cost-effective.en
dc.format.extent501301
dc.language.isoeng
dc.relation.ispartofResearch in Social and Administrative Pharmacy
dc.subjectAcute medicine
dc.subjectClinical pharmacy
dc.subjectCost effectiveness
dc.subjectMeta-analysis
dc.subjectSystematic review
dc.subjectPharmacy
dc.subjectPharmaceutical Science
dc.titleEffectiveness and cost effectiveness of pharmacist input at the ward level: a systematic review and meta-analysisen
dc.contributor.institutionDepartment of Pharmacy, Pharmacology and Postgraduate Medicine
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionDepartment of Clinical and Pharmaceutical Sciences
dc.description.statusPeer reviewed
dc.date.embargoedUntil2019-10-19
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85055699097&partnerID=8YFLogxK
rioxxterms.versionofrecord10.1016/j.sapharm.2018.10.006
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


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