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].