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Purpose: To evaluate the costs and benefits of clinical pharmacy services (CPS) in studies published between 2006 and 2010. This report focuses on study methods, CPS setting and type, and a comparison with a previous report.
Methods: Scientific literature databases (Medline, IPA, Embase, and CINAHL) for 2006-2010 were searched to identify studies describing CPS. Studies meeting inclusion criteria (original research; evaluation of CPS; economic and clinical outcomes sufficiently described) were reviewed by two investigators. Methodology employed, economic evaluation type, CPS setting and type, and clinical and economic outcome results were abstracted. Chi-square was used to compare 2006-2010 with the 2001-2005 study.
Results: The initial search identified 3587 potential studies. Twenty-five meeting inclusion underwent full review. Common CPS settings were hospital (40.0%), community (36.0%) and clinic (28.0%). The most common CPS types were disease state management (48.0%), general pharmacotherapeutic monitoring (44.0%), patient education or cognitive service (32.0%), and target drug programs (20.0%). Two (8.0%) studies stated that the CPS was medication therapy management. Disease state management programs were evaluated more frequently in the current period (2006-2010: 48.0% vs. 2001-2005: 22.6%; p=0.02). A control was included in 84.0% (21/25) of studies from 2006-2010, compared with 43.0% (40/93; p<0.001) from 2001-2005. Most of the 2006-2010 studies (17/25; 68.0%) involved a full economic evaluation, compared with 48.4% (45/93) in 2001-2005.
Conclusion: Fewer studies documented the economic impact of CPS in 2006-2010 than in 2001-2005 although the quality of the studies improved, evidenced by a higher proportion involving controlled designs and full economic evaluations. A significantly greater proportion involved disease state management. A trend toward more outpatient evaluations (community and clinic) was also observed. It is unclear whether the observed reduction in published papers is due to changes in practice, research funding, reduced need for documentation of CPS, or decreased journal acceptance of such reports.