Evidence of the clinical effectiveness of cognitive pharmaceutical services for aged patients

Sáez-Benito, L; Fernandez-Llimos, F; Feletto, E; Gastelurrutia, MA; Martinez-Martinez, F; Benrimoj, SI

Evidence of the clinical effectiveness of cognitive pharmaceutical services for aged patients

Sáez-Benito, L Fernandez-Llimos, F

Feletto, E Gastelurrutia, MA Martinez-Martinez, F Benrimoj, SI

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Publication Type:: Journal Article
Citation:: Age and Ageing, 2013, 42 (4), pp. 442 - 449
Issue Date:: 2013-07-01

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Field	Value	Language
dc.contributor.author	Sáez-Benito, L	en_US
dc.contributor.author	Fernandez-Llimos, F https://orcid.org/0000-0002-8529-9595	en_US
dc.contributor.author	Feletto, E	en_US
dc.contributor.author	Gastelurrutia, MA	en_US
dc.contributor.author	Martinez-Martinez, F	en_US
dc.contributor.author	Benrimoj, SI https://orcid.org/0000-0001-9768-7838	en_US
dc.date.issued	2013-07-01	en_US
dc.identifier.citation	Age and Ageing, 2013, 42 (4), pp. 442 - 449	en_US
dc.identifier.issn	0002-0729	en_US
dc.identifier.uri	http://hdl.handle.net/10453/23656
dc.description.abstract	Background: Cognitive pharmaceutical services (CPSs) encompass a variety of pharmacists' interventions to optimise pharmacotherapy. The clinical effectiveness of CPSs for aged patients remains controversial. Objective: To analyse and describe the evidence of theclinical effectiveness of CPSs in aged patients by means of performing a systematic review of systematic reviews. Methods: Using the recommended methodology by Cochrane, a searchwas undertaken for systematic reviews of the clinical effectiveness of CPSs in MEDLINE, EMBASE, DOAJ, SCIELO and COCHRANE LIBRARY. Reviews were assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) instrument. Quality of the evidence in the reviews was ranked using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: A total of 14 systematic reviews and one meta-analysis were analysed. The overall quality of the reviews was moderate. High and moderate strength of evidencewas found for the positive effect of certain CPSs on reducing the number and improving the appropriateness of medicines. There was conflicting evidence of the effect on adherence. There was limited evidence of high and moderate strength on clinical outcomes. No positive evidence was found on mortality, hospitalisations, functional capacity and cognitive function. No systematic reviews reported the effect on the level of control of health problems. Conclusions: certain types of CPSs reduce the number of medicines and improve the appropriateness of prescriptions. Longer follow-up periods and/or the use of surrogate clinical variables measuring the short-term impact are required to demonstrate the effect on clinical outcomes. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.	en_US
dc.relation.ispartof	Age and Ageing	en_US
dc.relation.isbasedon	10.1093/ageing/aft045	en_US
dc.subject.classification	Geriatrics	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Drug Therapy	en_US
dc.subject.mesh	Health Knowledge, Attitudes, Practice	en_US
dc.subject.mesh	Cognition	en_US
dc.subject.mesh	Evidence-Based Medicine	en_US
dc.subject.mesh	Age Factors	en_US
dc.subject.mesh	Aging	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Health Services for the Aged	en_US
dc.subject.mesh	Medication Therapy Management	en_US
dc.subject.mesh	Medication Adherence	en_US
dc.subject.mesh	Comparative Effectiveness Research	en_US
dc.subject.mesh	Inappropriate Prescribing	en_US
dc.subject.mesh	Drug-Related Side Effects and Adverse Reactions	en_US
dc.title	Evidence of the clinical effectiveness of cognitive pharmaceutical services for aged patients	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	42	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1701 Psychology	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	42	en_US

Abstract:

Background: Cognitive pharmaceutical services (CPSs) encompass a variety of pharmacists' interventions to optimise pharmacotherapy. The clinical effectiveness of CPSs for aged patients remains controversial. Objective: To analyse and describe the evidence of theclinical effectiveness of CPSs in aged patients by means of performing a systematic review of systematic reviews. Methods: Using the recommended methodology by Cochrane, a searchwas undertaken for systematic reviews of the clinical effectiveness of CPSs in MEDLINE, EMBASE, DOAJ, SCIELO and COCHRANE LIBRARY. Reviews were assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) instrument. Quality of the evidence in the reviews was ranked using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: A total of 14 systematic reviews and one meta-analysis were analysed. The overall quality of the reviews was moderate. High and moderate strength of evidencewas found for the positive effect of certain CPSs on reducing the number and improving the appropriateness of medicines. There was conflicting evidence of the effect on adherence. There was limited evidence of high and moderate strength on clinical outcomes. No positive evidence was found on mortality, hospitalisations, functional capacity and cognitive function. No systematic reviews reported the effect on the level of control of health problems. Conclusions: certain types of CPSs reduce the number of medicines and improve the appropriateness of prescriptions. Longer follow-up periods and/or the use of surrogate clinical variables measuring the short-term impact are required to demonstrate the effect on clinical outcomes. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

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http://hdl.handle.net/10453/23656