Pharmacist-Led Medication Reviews: A Review of Clinical Utility and Cost-Effectiveness

Adverse drug events refer to medication errors, adverse drug reactions, allergic reactions, and overdosesand represent an important burden on the Canadian population and healthcare system. In 2010–11, an estimated 1 in 1,000 non-seniors, and 1 in 200 seniors aged 65 years and older were hospitalized due to adverse drug events in Canada. More broadly, it has been estimated that between 1 and 25% of all hospital and emergency department visits are associated with adverse drug reactions; approximately 25% of which are admitted to hospital.Pharmacist-led medication reviews aim to improve patient outcomes by preventing adverse drug events and decreasing healthcare utilization.– Definitions of pharmacist-led medication reviews vary across jurisdictions and organizations. They can include services such as medication assessments, care plans, and follow-up evaluations.There is a substantial body of evidence describing the clinical effectiveness of these interventions. This body of evidence is diverse and varied in the populations, interventions, comparators, outcomes, and settings it covers. In 2017, Jokanovic et al., published an overview of systematic reviews that aimed to describe the body of evidence on pharmacist-led medication reviews in community settings.Jokanovic et al. conducted a comprehensive literature search for studies published between 1995 and December 2015. The review included 31 systematic reviews consisting of a total of 297 primary studies. Eighteen outcomes were reported across the body of evidence, with medication management, blood pressure control, healthcare utilization, diabetes control, improved cholesterol targets, and mortality the most commonly reported clinical outcomes; and quality of life and adherence the most commonly reported humanistic outcomes. In considering the body of SR evidence, the authors concluded that medication reviews improved various clinical outcomes among patients with various medical conditions.The aim of this report is to summarize the evidence regarding the clinical utility and cost-effectiveness of pharmacist-led medication reviews in the community setting, published since the Jokanovic et al. overview, in order to inform decision making around reimbursement.