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. 2023 Apr 5:14:1143444.
doi: 10.3389/fphar.2023.1143444. eCollection 2023.

Clinical, economic and humanistic outcomes of medication therapy management services: A systematic review and meta-analysis

Zhi-Jie Deng  1 , Lin Gui  1 , Jing Chen  1 , Shun-Shun Peng  1 , Yu-Feng Ding  1 , An-Hua Wei  1
Affiliations

Clinical, economic and humanistic outcomes of medication therapy management services: A systematic review and meta-analysis

Zhi-Jie Deng et al. Front Pharmacol. .

Abstract

Background: Medication therapy management (MTM) services is a method that can effectively improve patients' conditions, but the efficacy of economic and humanistic outcomes remain unclear. This systematic review and meta-analysis aim to use economic, clinical and humanistic outcomes to evaluate the multi-benefits of MTM services. Method: A systematic review and meta-analysis was conducted by retrieving PubMed, EMBASE, the Cochrane Library and ClinicalTrial.gov from the inception to April 2022. There were two reviewers screening the records, extracting the data, and assessing the quality of studies independently. Results: A total of 81 studies with 60,753 participants were included. MTM services were more effective in clinical outcomes with decreasing the rate of readmission (OR: 0.78; 95% CI: 0.73 to 0.83; I2 = 56%), emergency department visit (OR: 0.88; 95% CI: 0.81 to 0.96; I2 = 32%), adverse drug events (All-cause: OR: 0.68; 95% CI: 0.56 to 0.84; I2 = 61%; SAE: OR: 0.51; 95% CI: 0.33 to 0.79; I2 = 35%) and drug-related problems (MD: -1.37; 95% CI: -2.24 to -0.5; I2 = 95%), reducing the length of stay in hospital (MD: -0.74; 95% CI: -1.37 to -0.13; I2 = 70%), while the economic and humanistic outcomes were less effective. Conclusion: Our systematic review and meta-analysis demonstrated that MTM services had great ability to improve patients' clinical conditions while the efficacy of economic and humanistic outcomes, with some of the outcomes showing high degree of heterogeneity and possible publication bias, required more future studies to provide stronger evidence. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=349050], identifier [CRD42022349050].

Keywords: clinical; economic; humanistic; medication therapy management; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
Summaries of risk of bias assessment. (A) Risk of Bias 2; (B) ROBINS-I.
FIGURE 3
FIGURE 3
Details of risk of bias assessment. (A) Risk of Bias 2; (B) ROBINS-I.
FIGURE 4
FIGURE 4
Results of clinical outcomes. (A) Readmission; (B) ED visit; (C) Mortality; (D) All cause ADE; (E) SAE; (F) LoS; (G) DRPs; (H) MAI; (I) Summary of clinical outcomes.
FIGURE 5
FIGURE 5
Results of economic outcomes. (A) Total cost; (B) Medication cost; (C) Cost of hospitalization (D) Summary of economic outcomes.
FIGURE 6
FIGURE 6
Results of humanistic outcomes. (A) EQ-5D; (B) SF-Physical outcomes; (C) SF-Mental outcomes; (D) Adherence; (E) Summary of humanistic outcomes.
See this image and copyright information in PMC

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