Can clinical pharmacists affect SF-36 scores in veterans at high risk for medication-related problems?

BACKGROUND. An objective of pharmaceutical care is for pharmacists to impro ve patients' health-related quality of life (HRQOL) by optimizing medicatio n therapy. OBJECTIVES. The objective of this study was to determine whether ambulatory care clinical pharmacists could affect HRQOL in veterans who were likely t o experience a drug-related problem. RESEARCH DESIGN. This was a 9-site, randomized, controlled trial involving Veterans Affairs Medical Centers (VAMCs), Patients were eligible if they me t greater than or equal to3 criteria for being at high risk for drug-relate d problems. Enrolled patients were randomized to either usual medical care or usual medical care plus clinical pharmacist interventions. HRQOL was mea sured with the SF-36 questionnaire administered at baseline and at 6 and 12 months. RESULTS. In total, 1,054 patients were enrolled; 523 were randomized to int ervention, and 531 to control. After patient age, site, and chronic disease score were controlled for, the only domain that was significantly differen t between groups over time was the bodily pain scale, which converged to si milar values at the end of the study. Patients' rating; of the change in he alth status in the past 12 months was statistically different between group s, intervention patients declining less (-2.4 units) than control subjects (-6.3 units) (P < 0.004). This difference was not considered clinically mea ningful. However, a dose-response relationship was observed for general hea lth perceptions (P = 0.004), vitality (P = 0.006), and change in health ove r the past year (P = 0.007), CONCLUSIONS. These results suggest that clinical pharmacists had no signifi cant impact on HRQOL as measured by the SF-36 for veterans at high risk for medication-related problems.