Page 236 - EJMO-9-3

Eurasian Journal of
Medicine and Oncology ICU pharmacists and clinical outcomes

ventilator days, cost-related implications, and the broader CCPs; C (Comparison): care without CCPs; O (Outcomes):
clinical roles of CCPs such as antimicrobial stewardship, mortality and ADEs; S (Study Design): randomized
pharmacotherapy optimization, and interdisciplinary controlled trials, prospective cohort studies, and retrospective
care contributions. This comprehensive approach aims to observational studies. A comprehensive and systematic
21
inform evidence-based policy and practice regarding the literature search was performed across three major electronic
integration of pharmacists into critical care teams. databases: PubMed, Embase, and the Cochrane Library. The
search spanned from database inception through January
2. Methods 2025. Keywords and Medical Subject Headings included

2.1. Study design “intensive care unit,” “critical care pharmacists,” “adverse
drug events,” “death,” and “multidisciplinary.” The specific
This investigation was designed as a systematic review search strategies for each database are detailed in Table 1.
and meta-analysis, adhering to both the Meta-analysis of Boolean operators (AND and OR) were employed to ensure
Observational Studies in Epidemiology framework and a sensitive and inclusive search.
the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses guidelines. Its primary aim was to Duplicate entries were removed using EndNote software,
20
consolidate and evaluate existing evidence on the clinical after which two reviewers independently screened the
impact of integrating CCPs within ICU teams, specifically remaining titles and abstracts. Full-text versions of studies
focusing on two key outcomes: patient mortality and deemed potentially eligible were retrieved and evaluated
the incidence of ADEs. The study is registered in the for inclusion according to the predefined criteria.
International Prospective Register of Systematic Reviews 2.4. Data collection and quality evaluation
under the number CRD420251080799.
Data were systematically collected using a standardized
2.2. Eligibility criteria and pre-tested data extraction form. From each eligible
Study selection was guided by clearly defined inclusion study, the following key information was obtained:
and exclusion criteria established in advance to maintain (i) First author and publication year
methodological integrity and ensure the relevance of the (ii) Country and healthcare setting
included research. (iii) Study design and duration
(iv) Number of participants in the intervention and
Inclusion criteria were as follows: control groups
(i) The analysis encompassed a range of study designs, (v) Patient characteristics
including randomized controlled trials, prospective cohort (vi) Nature of the pharmacist intervention
studies, and retrospective observational investigations. (vii) Clinical outcomes (mortality and ADEs)
(ii) The patient population consisted exclusively of (viii) Reported effect sizes and confidence intervals (CIs).
individuals admitted to ICUs.
(iii) The intervention involved the integration or presence
of CCPs as active members of the ICU care team. Table 1. Structured search strategies used across selected
(iv) The study reported clinical outcomes, specifically databases
mortality and/or ADEs, comparing an intervention Database Search strategy
group (with CCPs) against a control group (without PubMed #1 “critical care pharmacists” (MeSH Terms) OR “intensive
CCP involvement). care unit” (MeSH Terms) OR “adverse drug events”
Exclusion criteria were as follows: (All Fields)
#2 “multi-disciplinary” (MeSH Terms) OR “death”
(i) Studies that did not explicitly evaluate the impact of (All Fields)
CCPs on either mortality or ADEs. #3 #1 AND #2
(ii) Studies where the intervention involved pharmacy Embase “critical care pharmacists”/exp OR “intensive care unit”/
services not specific to critical care or not clearly exp OR “adverse drug events”/exp
involving pharmacists embedded in ICU teams. #2 “multidisciplinary”/exp OR “death”/exp
(iii) Publications lacking a comparison group, such as single- #3 #1 AND #2
arm studies, editorials, review articles, conference Cochrane #1 (critical care pharmacists): ti, ab, kw OR (intensive care
abstracts, commentaries, or letters to the editor. Library unit): ti, ab, kw OR (adverse drug events): ti, ab, kw
(Word variations have been searched)
2.3. Literature search strategy #2 (multidisciplinary): ti, ab, kw OR (death): ti, ab, kw
(Word variations have been searched)
The search strategy was based on the PICOS framework: #3 #1 AND #2
P (Population): ICU patients; I (Intervention): involvement of Abbreviation: MeSH: Medical Subject Headings.

Volume 9 Issue 3 (2025) 228 doi: 10.36922/EJMO025150116