Impact of pharmacist-led interventions on medication-related problems among patients treated for cancer: A systematic review and meta-analysis of randomized control trials

Atalay Mulu Fentie; Solomon Assefa Huluka; Girma Tekle Gebremariam; Gebremedhin Beedemariam Gebretekle; Ephrem Abebe; Teferi Gedif Fenta

doi:10.1016/j.sapharm.2024.02.006

Impact of pharmacist-led interventions on medication-related problems among patients treated for cancer: A systematic review and meta-analysis of randomized control trials

Res Social Adm Pharm. 2024 May;20(5):487-497. doi: 10.1016/j.sapharm.2024.02.006. Epub 2024 Feb 14.

Authors

Atalay Mulu Fentie¹, Solomon Assefa Huluka², Girma Tekle Gebremariam², Gebremedhin Beedemariam Gebretekle³, Ephrem Abebe⁴, Teferi Gedif Fenta⁵

Affiliations

¹ Addis Ababa University, College of Health Sciences, School of Pharmacy, Department of Pharmacology and Clinical Pharmacy, Ethiopia. Electronic address: atalay.mulu@aau.edu.et.
² Addis Ababa University, College of Health Sciences, School of Pharmacy, Department of Pharmacology and Clinical Pharmacy, Ethiopia.
³ University Health Network, Toronto Health Economics and Technology Assessment (THETA) Collaborative, Canada.
⁴ Purdue University, College of Pharmacy, West Lafayette, IN, USA; Indiana University, School of Medicine, Indianapolis, IN, USA.
⁵ Addis Ababa University, College of Health Sciences, School of Pharmacy, Department of Social Pharmacy and Pharmaceutics, Ethiopia.

PMID: 38368123
DOI: 10.1016/j.sapharm.2024.02.006

Abstract

Background: Medication-related problems (MRPs) continue to impose a voluminous health impact, particularly among patients on anti-cancer therapy, due to the nature and complexity of the care. Pharmacists have a pivotal role in ensuring the safe, effective, and rational use of medicines in this group of patients.

Objectives: To examine the impact of pharmacist-led interventions in resolving MRPs among patients treated for cancer.

Methods: This systematic review and meta-analysis was conducted and reported following the PRISMA protocol and registered in PROSPERO (Registration number: CRD42022311535). Four database searches, PubMed, EMBASE, Cochrane, and International Pharmaceuticals Abstracts, were systematically searched from August 2022 to January 2023. Only randomized control trials (RCTs) were included. The Cochrane risk of bias assessment tool was used to check the quality of the included studies. The outcome measures were overall MRPs, adherence, medication errors, and adverse drug events (ADEs). Data for meta-analysis were analyzed used using STATA version 17 and standardized mean difference effect sizes were calculated for continuous outcomes and odds ratio for categorical outcomes.

Results: Out of the 90 studies screened for eligibility, 20 RCT studies were included for the systematic review and 15 for the meta-analysis. Close to two-thirds of the studies were from Europe (n = 7) and Asia (n = 6). A combination of educational and behavioral intervention strategies were used for a period ranged from 8 days to 12 months. The pharmacist-led intervention improved adherence to treatment by 4.79 times (AOR = 4.79; 95%CI = 2.64, 8.68; p-value<0.0001), reduced the occurrence of ADEs by 1.28 (SMD = -1.28; 95%CI = -0.04-2.52; p-value = 0.04) and decreased the overall MRPs by 0.53 (SMD = -0.53; 95%CI = -0.79, -0.28; p-value<0.0001) compared to control groups.

Conclusion: This study found out that pharmacist-led interventions can significantly lower MRPs among patients treated for cancer. Hence, a global concerted effort has to be made to integrate pharmacists in a multidisciplinary direct cancer care.

Keywords: Adherence; Adverse drug events; Cancer; Medication-related problems; Meta-analysis; Pharmacist.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Europe
Humans
Medication Errors
Neoplasms* / drug therapy
Outcome Assessment, Health Care
Pharmacists*