Effect and Economic Evaluations of Pharmaceutical Care in China: A Systematic Review

OBJECTIVES: To elaborate the value of pharmaceutical care, and sort out the existing problems in the current researches on the effect and value evaluation of pharmaceutical care.

METHODS: We conducted a qualitative systematic review by searching seven database (inception to December 2021). We did not restrict the types of studies, diseases and drugs included. Two reviewers independently screened the studies, extracted data, conducted the statistical analysis and assessed the quality of full economic evaluations. The pharmaceutical care was divided into 9 types based on the relevant standards of Chinese Hospital Association.

RESULTS: 332 studies were included. The first study was published in 2004, and the number of studies has increased significantly over time. 93.67% of the literatures were published in Chinese journals. the participants included were mainly hospitalized patients (n=173, 52.11%). The methods were mainly randomized controlled trials (RCTs) (n=124, 37.35%) and cohort studies (n=187,56.32%). Only 23 studies were conducted as full economic evaluations, and merely 8 of them introduced the research perspectives. The Quality of Health Economic Studies (QHES) score was 61.22±12.80. The most commonly used effect indicators included length of stay (n=166, 50%), prescription rationality rate (n=166, 50%), incidence of adverse reactions (n=117, 35.24%) and course of medication (n=107, 32.23%). Most of the research results showed that pharmaceutical care could improve the therapeutic effect. For economic indicators, the cost of medication (n=269, 81.02%) and hospitalization (n=113, 34.04%) were the most frequently used indicator, 91.45% and 81.42% of the studies revealed that pharmaceutical care could reduce the cost of medication and hospitalization.

CONCLUSIONS: Pharmaceutical care can improve the therapeutic effect and save the cost of treatment. However, the methodology of pharmaceutical care effect and economic evaluation needs to be further improved. Future researches should be more inclined to use full economic evaluation methods.