Introduction

Autoimmune disorders are chronic, self-mediated, misdirected immune responses against their own immune system. It required intensive, complex and costly drug treatment regimen increased the risk of pharmacotherapy error and adversely affects patients. Hence, pharmacist care will have vital roles in autoimmune disorders to achieve health related outcomes.

Objectives

This review aimed to gather evidence on the impact of pharmacist care on clinical, humanistic and economic outcomes, adherence to medications, and drug related problems in the management of autoimmune disorders among the usual care group.

Methodology

A comprehensive review conducted in compliance with the PRISMA statement and systematic search was performed across five databases included PubMed Central, Web of Sciences, Scopus, Cochrane Library and google scholar from inception until August 2020. This research included full-text articles of randomized and non-randomized studies that evaluated impact of pharmacist care in autoimmune disorders.

Results

A total of nine studies were included (seven RCTs and two non-RCTs), including 829 patients with autoimmune disorders. A total of four studies (80%) show an enhancement in at least one clinical parameter due to pharmacist care. A substantial improvement in at least one humanistic parameter observed in all five studies (100%). While four out of five studies (80%) clearly displayed a remarkable improvement in medication adherence in the pharmacist care group from baseline to the completion of follow-ups. One study quantified a 99.08% resolution of DRPs in the pharmacist care group. Another study estimated the cost of medical resources uses per patient and found no difference in cost-effectiveness over six months between groups.

Conclusion

This review reinforces the vital contribution of pharmacists to achieve clinical outcomes, humanistic outcomes, adherence to medications and DRPs in the efficient management of autoimmune disorders. However, no notable changes in economic outcomes were observed in this review.

中文翻译：

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药剂师护理对自身免疫性疾病管理的影响：随机对照试验和非随机研究的系统评价

介绍

自身免疫性疾病是针对自身免疫系统的慢性、自我介导、误导性免疫反应。它需要密集、复杂和昂贵的药物治疗方案，增加了药物治疗错误的风险并对患者产生不利影响。因此，药剂师护理将在自身免疫性疾病中发挥重要作用，以实现与健康相关的结果。

目标

本综述旨在收集关于药剂师护理对临床、人文和经济结果、药物依从性以及常规护理组自身免疫性疾病管理中药物相关问题的影响的证据。

方法

从开始到 2020 年 8 月， 在包括 PubMed Central、Web of Sciences、Scopus、Cochrane Library 和google Academic 在内的五个数据库中进行了符合 PRISMA 声明和系统搜索的全面审查。这项研究包括随机和非-评估药剂师护理对自身免疫性疾病影响的随机研究。

结果

共纳入九项研究（七项 RCT 和两项非 RCT），包括 829 名自身免疫性疾病患者。共有四项研究 (80%) 显示，由于药剂师的护理，至少一项临床参数有所提高。在所有五项研究中都观察到至少一项人文参数的显着改善（100%）。五分之四的研究 (80%) 清楚地表明，从基线到完成随访，药剂师护理组的药物依从性显着改善。一项研究量化了药剂师护理组中 99.08% 的 DRP 分辨率。另一项研究估计了每位患者的医疗资源使用成本，发现两组之间的成本效益在六个月内没有差异。

结论

本综述强调了药剂师在有效管理自身免疫性疾病中实现临床结果、人文结果、药物依从性和 DRP 的重要贡献。然而，在本次审查中没有观察到经济结果的显着变化。