Effectiveness
Under the premise of drug safety as the cornerstone, high-quality
pharmaceutical care needs to pursue the optimization of drug treatment
through the intervention of pharmacists [1]. For
instance, a randomized controlled trial comparing home blood pressure
monitoring, network communication and pharmacist care for hypertension
control showed that pharmacist care played the most significant role in
reducing patients’ diastolic blood pressure [27]; in a 2015 trial to
evaluate the 6-month blood pressure of patients with uncontrolled
hypertension, pharmacist prescription intervention reduced not only the
patient’s diastolic blood pressure, but also the participants’ systolic
blood pressure [28]. The antihypertensive treatment trials under the
intervention of these pharmacists all showed the enthusiasm of
pharmaceutical clinical service. Consequently, pharmacists trained in
cardiovascular care should be encouraged to participate more in the
long-term treatment of patients with hypertension [29]. Pharmacist
intervention can increase the efficacy not only in cardiovascular
disease, but also in depression and hepatitis C virus antiviral therapy:
The subjects asked pharmacists to receive psychological intervention
training in behavioral activation therapy, and found that pharmacists
who had temporary psychosocial intervention were more effective in
treating patients with depression for a longer time [30]; a
randomized trial led by pharmacists to analyze the antiviral effects of
hepatitis C virus patients receiving opioid replacement therapy showed
that the participation of pharmacists showed higher detectability and
treatability to patients. and improved the success rate of treatment
[31].
As an important measure that has been neglected to ensure the curative
effect for a long time, medication compliance is directly manifested by
the irregularity or even non-use of medication by patients, which is the
simplest way to ensure the effectiveness of drug treatment. Medication
compliance is a dynamic process, which will decrease with the passage of
time, and for patients who need long-term medication or painful
medication, low compliance will make patients unwilling to follow the
medication regimen. And it will eventually lead to treatment failure,
reduction of treatment effect or even inefficacy or rebound, which is
very tricky. Thus, if the pharmacist intervenes based on compliance, it
will have a non-negligible impact on the overall quality of treatment
[32], especially cardiovascular diseases, asthor ma [33]
vaccination [34]: As early as in a research trial in 1973, a
research group used pharmacists to popularize hypertension knowledge to
patients, so as to improve patients’ mastery of hypertension knowledge,
so as to improve drug compliance and achieve the purpose of controlling
patients’ blood pressure[35]. Similarly, patients with chronic heart
failure also improved their quality of life due to interdisciplinary
intervention in pharmacies [36]; a similar effect is reflected in
the treatment of patients with asthma: A systematic review and
meta-analysis of asthma compliance shows that pharmacists can use
correct training and knowledge to help patients adhere to the
prescription, take medicine regularly, and greatly improve asthma
compliance [33]; And from the point of view of improving compliance,
cooperation and pre-planning between pharmacists and nurses can make
targeted recommendations to make pneumococcal vaccines more available
[34].
The risk of death and readmission can reflect the prognosis of patients
with curative effect. For diseases or combination drugs that may have a
poor prognosis, researchers try to make use of the special technical
functions of pharmacists and finally achieve more positive results. For
example, in primary care, although low-intensity cooperative
intervention by pharmacists had no positive effect on clinical outcomes
in people who received relatively good treatment at the baseline level,
it can improve the prognosis of patients with left ventricular systolic
dysfunction [37]; Multifaceted pharmacist intervention had a
significant impact on reducing the readmission time of 30 days and 180
days for multidrug adults in hospital [38]; Moreover, a recent
cohort study demonstrated the positive role of pharmaceutical care in
reducing short-term mortality or the risk of readmission in the elderly,
and discussed the possible correlation between improved prognosis and
changes in drug compliance [39].