Impact of pharmacist-delivered interventions on pain-related outcomes: An umbrella review of systematic reviews and meta-analyses.

Journal: Research in social & administrative pharmacy : RSAP

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Affiliated Institutions:  School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia. Electronic address: Sunil.shrestha@monash.edu. Office of Lifelong Learning and the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, AB, TGC, Edmonton, Canada. Electronic address: aiqbal@ualberta.ca. School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia. Electronic address: Teoh.Siew.Li@monash.edu. Health Economics Consulting, Norwich Medical School, University of East Anglia, Bob Champion Research & Education Building, UEA Research Park Rosalind Franklin Rd, NR UQ, Norwich, United Kingdom. Electronic address: khanalsaval@gmail.com. School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia. Electronic address: Gan.SiewHua@monash.edu. School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia; School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia; Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well Being Cluster, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia; Global Asia in the st Century (GA) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia. Electronic address: shaun.lee@monash.edu. School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham Edgbaston, Birmingham, United Kingdom; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom. Electronic address: v.paudyal@bham.ac.uk.

Abstract summary 

Pain is a significant healthcare challenge, impacting millions worldwide. Pharmacists have increasingly taken on expanded roles in managing pain, particularly in primary and ambulatory care contexts. This umbrella review aims to systematically evaluate evidence from published systematic reviews that explore the impact of pharmacist-delivered interventions on clinical, humanistic, and economic outcomes related to pain.A systematic search was conducted across six electronic databases, including Ovid Embase, MEDLINE, CINAHL, Scopus, CENTRAL, APA PsycINFO, and DARE, from inception until June 2023. Prior to inclusion, two independent reviewers assessed study titles and abstracts. Following inclusion, an assessment of the methodological quality of the included studies was conducted. AMSTAR 2 was used to evaluate the methodological quality of the included SRs.From 2055 retrieved titles, 11 systematic reviews were included, with 5 out of 11 being meta-analyses. These SRs encompassed diverse pharmacist-led interventions such as education, medication reviews, and multi-component strategies targeting various facets of pain management. These findings showed favorable clinical outcomes, including reduced pain intensity, improved medication management, enhanced overall physical and mental well-being, and reduced hospitalization durations. Significant pain intensity reductions were found due to pharmacists' interventions, with standardized mean differences (SMDs) ranging from -0.76 to -0.22 across different studies and subgroups. Physical functioning improvements were observed, with SMDs ranging from -0.38 to 1.03. Positive humanistic outcomes were also reported, such as increased healthcare provider confidence, patient satisfaction, and quality of life (QoL). QoL improvements were reported, with SMDs ranging from 0.29 to 1.03. Three systematic reviews examined pharmacist interventions' impact on pain-related economic outcomes, highlighting varying cost implications and the need for robust research methodologies to capture costs and benefits.This umbrella review highlights the effectiveness of pharmacist-delivered interventions in improving clinical, humanistic, and economic outcomes related to pain management. Existing evidence emphasises on the need to integrate pharamacists into multi-disciplinary pain management teams. Further research is needed to investigate innovative care models, such as pharmacist-independent prescribing initiatives within collaborative pain management clinics.

Authors & Co-authors:  Shrestha Iqbal Teoh Khanal Gan Lee Paudyal

Study Outcome 

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Statistics
Citations : 
Authors :  7
Identifiers
Doi : S1551-7411(24)00091-3
SSN : 1934-8150
Study Population
Male,Female
Mesh Terms
Other Terms
Cancer pain;Pharmaceutical services;Pharmacist;Umbrella review
Study Design
Study Approach
Country of Study
Publication Country
United States