Influence of Clinical Pharmacist's Interventions on Clinical Outcomes of Patients With Pneumonia in the Emergency Department of Tertiary Care Healthcare Setting

The aims of the study were to evaluate the services of emergency medicine pharmacists in patient care and to assess the need to implement clinical pharmacy practice in emergency department. This study analyzed English language articles, which were identified and studied according to the inclusion criteria. The articles were identified from different databases from 1982 to 2020. Two hundred fifty articles were primarily searched for inclusion criteria and a preferred reporting items for systematic reviews and meta-analyses diagram was created to describe qualitative analysis. Quality assessment of the studies was done using the strengthening the reporting of observational studies in epidemiology checklist. A total of 9 studies were quality assessed and included for evidence synthesis. Four studies showed a significant reduction in readmission rate P < 0.0001 with an odds ratio (OR) of 1.6341 for the patients with the pharmacist care group. Patient's in-hospital mortality and appropriateness of medications had an OR of 3.2196 (P = 0.0353) and 0.1444 (P = 0.0001), respectively. The pooled OR (n = 1026) in 4 studies was 1.4534 (95% confidence interval = 0.2844-0.7292) in antibiotic guidelines for pharmacist interventions. In addition, evidence showed a statistically significant reduction in hospital revisits (P < 0.00001, OR = 2.05, 95% confidence interval = 1.76-2.39) with the pharmacist in the emergency department compared with no pharmacist. The meta-analysis concluded that clinical pharmacy interventions in the ambulatory setting had a positive impact on clinical outcomes related to disease management, medication optimization, ensuring patient safety, and providing quality of care. Studies identified did not evaluate the impact of pharmacists on cost-effectiveness, which is a useful direction for future study.