Impact of pharmacist services on economic, clinical, and humanistic outcome (ECHO) of South Asian patients: a systematic review

Shrestha, Sunil, Shrestha, Rajeev, Ahmed, Ali, Sapkota, Binaya, Khatiwada, Asmita Priyadarshini, Christopher, Christina Malini, Thapa, Parbati, KC, Bhuvan, Blebil, Ali Qais, Khanal, Saval ORCID: and Paudyal, Vibhu (2022) Impact of pharmacist services on economic, clinical, and humanistic outcome (ECHO) of South Asian patients: a systematic review. Journal of Pharmaceutical Policy and Practice, 15. ISSN 2052-3211

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Background: Pharmacists in high-income countries routinely provide efficient pharmacy or pharmaceutical care services that are known to improve clinical, economic, and humanistic outcomes (ECHO) of patients. However, pharmacy services in low- and middle-income countries, mainly South Asia, are still evolving and limited to providing traditional pharmacy services such as dispensing prescription medicines. This systematic review aims to assess and evaluate the impact of pharmacists’ services on the ECHO of patients in South Asian countries.   Methods: We searched PubMed/Medline, Scopus, EMBASE, CINAHL, and Cochrane Library for relevant articles published from inception to 20th September 2021. Original studies (only randomised controlled trials) conducted in South Asian countries (published only in the English language) and investigating the economic, clinical (therapeutic and medication safety), and humanistic impact (health-related quality of life) of pharmacists’ services, from both hospital and community settings, were included.   Results: The electronic search yielded 430 studies, of which 20 relevant ones were included in this review. Most studies were conducted in India (9/20), followed by Pakistan (6/20), Nepal (4/20) and Sri Lanka (1/20). One study showed a low risk of bias (RoB), 12 studies showed some concern, and seven studies showed a high RoB. Follow-up duration ranged from 2 to 36 months. Therapeutic outcomes such as HbA1c value and blood pressure (systolic blood pressure and diastolic blood pressure) studied in fourteen studies were found to be reduced. Seventeen studies reported humanistic outcomes such as medication adherence, knowledge and health-related quality of life, which were found to be improved. One study reported safety and economic outcomes each. Most interventions delivered by the pharmacists were related to education and counselling of patients including disease monitoring, treatment optimisation, medication adherence, diet, nutrition, and lifestyle.  Conclusion: This systematic review suggests that pharmacists have essential roles in improving patients’ ECHO in South Asian countries via patient education and counselling; however, further rigorous studies with appropriate study design with proper randomisation of intervention and control groups are anticipated.

Item Type: Article
Additional Information: Funding Information: The authors received no financial support for conducting this research work. The authors also acknowledge the support from the University of Birmingham to cover the open access fees for the article.
Uncontrolled Keywords: clinical and humanistic outcome (echo),economic,health-related quality of life (hrqol),pharmacist,south asia,pharmacy,pharmacology, toxicology and pharmaceutics(all),health policy,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/3600/3611
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 17 Apr 2023 13:31
Last Modified: 18 Apr 2023 11:30
DOI: 10.1186/s40545-022-00431-1

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