Impact of clinical pharmacist interventions in psychiatric hospitals on clinical and medication-related outcomes : a systematic review and meta-analysis

Štuhec, Matej (author), Balaško, Kaja (author), Gorjan Gazdag, Anteja (author), Čuk, Zala (author), Locatelli, Igor (author)

Introduction: Clinical pharmacist interventions have been shown to improve outcomes and reduce drug-related problems (DRPs) in patients with mental disorders. However, no previous meta-analysis has comprehensively evaluated their effectiveness in reducing DRPs and optimizing pharmacotherapy in psychiatric inpatient settings.Aim: To evaluate the effectiveness of clinical pharmacist interventions in psychiatric inpatient settings on DRPs and clinical outcomes among patients with mental disorders.Methods: This systematic review and meta-analysis was conducted according to the PRISMA 2020 statement and prospectively registered in PROSPERO (CRD420261309290). PubMed, Scopus, CENTRAL, and CINAHL were searched from inception to March 2026. Eligible studies included adult psychiatric inpatients receiving clinical pharmacist interventions, including different pharmaceutical services, such as medication review, medication reconciliation, and ward round participation. A meta-analysis was performed in R using a random-effects model. Heterogeneity was calculated using I$^2$. Random-effects meta-analyses were performed for DRPs, potentially inappropriate medications (PIMs), and the number of prescribed medications. Risk of bias was assessed using RoB two and ROBINS-I.Results: Eighteen studies met the inclusion criteria, including one randomized controlled trial and 17 non-randomized interventional studies. Clinical pharmacist interventions significantly reduced the number of prescribed medications (mean difference −1.0 medications per patient, (95% CI −1.5 to −0.5) and were associated with a pooled reduction in DRPs of 70.7% (95% CI 46.5–87.0), as well as reductions in PIMs. Evidence for patient-centred clinical outcomes, including symptom improvement, quality of life, and healthcare utilization, remained limited. Substantial heterogeneity was observed across studies, reflecting differences in intervention types, patient populations, and outcome measures. Most non-randomized studies were judged to have a serious risk of bias because of confounding and uncontrolled study designs.Conclusion: Clinical pharmacist interventions in psychiatric inpatient settings improve medication-related outcomes by reducing DRPs, PIMs, and the number of prescribed medications. These findings support the integration of clinical pharmacists into multidisciplinary psychiatric teams. Further adequately powered multicentre randomized controlled trials are needed to determine whether these improvements translate into better long-term patient-centred clinical outcomes.

• Language: English
• Keywords: clinical pharmacy, drug-related problems, mental disorders, meta-analysis, psychiatric hospitals
• Work type: Article
• Typology: 1.02 - Review Article
• Organization: FFA - Faculty of Pharmacy
• Publication status: Published
• Publication version: Version of Record
• Year: 2026
• Number of pages: 14 str.
• Numbering: Vol. 18, art. 1945082
• PID: 20.500.12556/RUL-189729
• UDC: 614.212:616.89:615
• ISSN on article: 1663-9812
• DOI: 10.3389/fphar.2026.1945082
• COBISS.SI-ID: 294153475
• Publication date in RUL: 14.10.2026

Record is a part of a journal

• Title: Frontiers in pharmacology
• Shortened title: Front Pharmacol
• Publisher: Frontiers Media
• ISSN: 1663-9812
• COBISS.SI-ID: 29551833

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: težave, povezane z zdravili, duševne motnje, metaanaliza, klinična farmacija, psihiatrične bolnišnice, zdravila

Projects

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: J3-50127
• Name: Intervencije kliničnega farmacevta v psihiatričnih bolnišnicah pri bolnikih z duševnimi motnjami: vpliv na težave povezane z zdravili

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: P1-0189
• Name: Farmacevtska tehnologija: od dostavnih sistemov učinkovin do terapijskih izidov zdravil pri otrocih in starostnikih