The Role of the Pharmacist as a Member of a Multidisciplinary Team in Wound Management - A Systematic Review 1 Aisling English (Final Year Pharmacy Undergraduate Student) 2 Dr Zena Moore (Supervisor) 1 School of Pharmacy, 2Faculty of Nursing & Midwifery , 1,2Royal College of Surgeons in Ireland, Dublin 2, Ireland

Background

Wounds are a significant global problem impacting negatively on health and social gain

Due to the complex nature of wounds, a multidisciplinary approach is required to ensure the delivery of cost effective, efficient care pathways1

Pharmacists, as members of an integrated wound team, have the potential to contribute to enhancing patient outcomes and delivery of care

Aims and Outcomes

The aim of this systematic review was to investigate the role of the pharmacist as a member

of a multidisciplinary team in wound management

Primary Outcomes

Reduction in wound severity Improved healing rates Reduction in wound infection Reduction in incidence

amputations

Secondary Outcomes

Reduction in costs Reduction in pain Reduction in nursing time Improved service delivery

Eligible Studies and Search Strategy

All studies which included a multidisciplinary approach to wound management with a particular emphasis on the role of the pharmacist were eligible for inclusion

The following databases were searched from 1993-2012

Pubmed

The Cochrane Library

Ovid EMBASE

EBSCO CINAHL

Web of Knowledge

Science Direct

Search Results

403 Hits 19 Articles Identified

12 Articles Retrieved

7 Papers Not

Eligible

5 Papers Eligible

Data Extraction and Analysis

Data were extracted onto pre-designed data extraction tables. Quality appraisal was per the CONSORT statement, as appropriate

Owing to the methodological diversity of the studies located, no meta analysis or meta synthesis was possible. Therefore a narrative summary of the studies was provided

Findings Three major themes related to some, but not all of

the primary and secondary outcomes, were identified

These themes included reference to:

Reduction in wound severity

Improved healing rates

Reduction in wound infection

Reduction in costs

Reduction in pain

Improved service delivery

Discussion

The three major themes were identified relating specifically to the pharmacist’s role in wound management and included:

Improving patient safety

Cost avoidance

Enhanced clinical outcomes

There was a lack of robust evidence to support or refute the role of the pharmacist in wound management

Discussion The pharmacist is an

integral member of the multidisciplinary group and has a key role in wound care

However, their role in wound management as a member of a multidisciplinary team has not been well researched

Conclusions and Implications for Research

This review identified three key areas where the pharmacist had an important impact: cost avoidance, enhancing clinical outcomes and improving patient safety

However, little evidence is available that has specifically explored their role

Further research in this area is warranted owing to the lack of attention to the pharmacist’s role in wound care

References 1. Bokhour, B.G. (2006) Communication in interdisciplinary team meetings: what are we

talking about? Journal of Inter-Professional Care. 20: 349-363

2. Vu, T., Harris, A., Duncan, G., Sussman, G. (2007) Cost effectiveness of multidisciplinary wound care in nursing homes: a pseudo-randomized pragmatic cluster trial. Family Practice.24: 372-379

3. Patel, N.P., Brandt, C., Yowler C.J. (2006) A prospective study of the impact of a critical care pharmacist assigned as a member of the multidisciplinary burn care team. J Burn Care Res. 27: 310-313

4. Baker, T.L., Boyce, J., Gairy, P., Mighty, G. (2011) Interprofessional management of a complex continuing care patient admitted with 18 pressure ulcers: a case report. Ostomy Wound Management. 57(2): 38-47

5. Bhowmik, D., Chiranjib, B., Yadav, J., Chandira, M.R. (2009) Role of community pharmacist in management and prevention diabetic foot ulcers and infection. Journal of Chemical and Pharmaceutical Research. 1(1): 38-53 6. Malek, J. (2008) Diabetic foot – what a pharmacist can do. Continuing Professional Development. 30: 656-658

6. The author is deeply grateful for the assistance and contributions of Ms. Grainne McCabe, Librarian, Royal College of Surgeons in Ireland (RCSI)

The Role of the Pharmacist as a Member of a Multidisciplinary Team in Wound Management - A Systematic Review 1 Aisling English (Final Year Pharmacy Undergraduate Student) 2 Dr Zena Moore (Supervisor) 1 School of Pharmacy, 2Faculty of Nursing & Midwifery , 1,2Royal College of Surgeons in Ireland, Dublin 2, Ireland