Pharmacist-led medication reviews: A scoping review of systematic reviews

Abstract

Abstract Background Medication reviews aim to support patients who take medicines, and they are often led by pharmacists. Previous research undertaken in 2015 found mixed evidence that medication reviews in community settings improve clinical outcomes, but further work needs to be undertaken to establish their impact on patient-orientated and economic outcomes. Aim To explore the extent and range of systematic reviews of medication reviews conducted by pharmacists, the nature of the intervention, the evidence for effectiveness, and reported research gaps. Method Data extracted included the design of included studies, population, setting, main results, description of interventions, and future research recommendations. Results We identified twenty-four systematic reviews which reported that medication review interventions were diverse, and their nature was often poorly described. Two high quality reviews reported that there was evidence of no effect on mortality; of these one reported an improvement in medicines-related problems (all studies reported an increase of identified problems), and another a reduction in hospital readmissions (Risk ratio 0.93). Other lower quality reviews reported evidence supporting intervention effectiveness for some clinical outcomes (odds ratio: achieving diabetes control = 3.11, achieving blood pressure target = 2.73, 3.50). Conclusion There is mixed evidence of effectiveness for medication reviews across settings and patient populations. The nature of the intervention is poorly reported therefore it is difficult to determine the components medication review. As medication reviews are widely implemented in practice, further research should explore the nature of the interventions and linking the components of these to outcomes.