OBJECTIVES: There is lack of synthesized evidence on the effectiveness of clinical pharmacy interventions on clinical outcomes like adverse events (AEs) and mortality, and economic outcomes of diabetes at hospital settings. The aim of this study was to examine the effectiveness of clinical pharmacy interventions on health and economic outcomes of patients with type 2 diabetes in hospital settings.

METHODS: MEDLINE, EMBASE, PsycInfo, CINAHL, COCHRANE Library were searched from 1990 to November 2020. We included randomized controlled and non‐randomized controlled trials, cohort, and controlled before‐after studies. Meta-analyses were undertaken for randomized controlled studies. Primary outcomes were glycosylated hemoglobin A1c (HbA1c), all-cause mortality, major cardiovascular events, AEs, quality of life, and economic outcomes.

RESULTS: We retrieved 11,853 studies of which 44 studies (n=8623 patients) were included in the review. Of these, 29 randomized controlled studies were included in the meta-analyses (n=4055 patients). Clinical pharmacy interventions significantly reduced HbA1c levels (standardized mean difference (SMD) −0.52, P < 0.001) and AEs compared to usual care. No eligible studies reported major cardiovascular events as outcomes. One study examined effectiveness of the interventions on all-cause mortality and no significant difference in all-cause mortality between intervention and usual care groups was reported. The interventions significantly improved quality of life, and significantly reduced costs of diabetes care including medical costs, costs of laboratory tests, cost of medications compared to usual care in both developed and developing countries.

CONCLUSIONS: Clinical pharmacy interventions showed effectiveness in diabetes control, reduction of AEs and costs of care compared to usual care. The effectiveness of the interventions on economic outcomes in developing countries has implications on improving diabetes care and reducing cost of care as prevalence of medication therapy problems in these countries is high. Future trials are warranted to establish whether such interventions have an impact on major cardiovascular outcomes.