Effects of Pharmacist Interventions on Hospitalization, Mortality, and Quality of Life in Asian Healthcare Environments: A Systematic Review and Meta-Analysis

Aim: This systematic review and meta-analysis assessed the effects of pharmacist interventions in Asian health care environments on hospitalization, mortality, and quality of life (QoL) among older people in Asia. Methods: A comprehensive search was conducted across 5 databases, encompassing studies from inception until December 2021. Only studies involving pharmacist interventions for people aged 65 years or older, residing in Asian countries, were considered. Studies without evidence of pharmacist involvement or conducted outside of Asia were excluded. Data extraction was independently performed by two reviewers, capturing key study characteristics, pharmacist intervention types, and outcome measures for subsequent meta-analyses. Forest plots were generated using a random effects model to obtain risk ratios or pooled standardized mean differences (SMD). Results: A total of 142 articles underwent thorough review, and ultimately, eight studies meeting the inclusion criteria were included in the meta-analyses. These studies encompassed diverse healthcare settings such as outpatient, inpatient, and nursing homes, with sample sizes ranging from 32 to 306 older adults. Pharmacist interventions were found to significantly reduce hospitalization rates (n=4, risk ratio: 0.64, 95% CI: 0.42-0.98) and mortality rates (n=4, risk ratio: 0.59, 95% CI: 0.38-0.92) among older people. However, the analysis did not reveal a significant improvement in QoL compared to usual care (n=5, SMD: 0.37, P = 0.208). Conclusions: These findings highlight the crucial role of pharmacists within healthcare teams in Asian countries. Pharmacist interventions have an impact on reducing hospitalization and mortality rates among the elderly, underscoring the importance of optimizing patient outcomes in Asia.