{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:56:54Z","timestamp":1781881014424,"version":"3.54.5"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of pharmaceutical care delivered by Chinese pharmacists during their professional role transformation, including prescription review, medication counseling, prescription comment, and the value of pharmacist interventions in multidisciplinary team settings, with the aim of providing evidence-based support for advancing the transformation and optimizing service models of the pharmacy workforce in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, Wanfang, and VIP from inception to April 2026. RCTs and NRSIs examining pharmacist-delivered pharmaceutical care in Chinese institutions were included. Risk of bias was assessed with Cochrane ROB and ROBINS-I. Meta-analyses used odds ratios (ORs) and 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-two studies (5 RCTs, 27 NRSIs) were included. Pharmacist interventions were associated with increased single-agent antimicrobial use (OR 3.13, 95%CI 2.49\u20133.92) and rational prescriptions (OR 2.97, 95%CI 2.30\u20133.85), and reduced combination therapy, irrational prescriptions (OR 0.22, 95%CI 0.17\u20130.28), as well as reduced irrational prescribing in intravenous admixture centers and outpatient settings (non-standard: OR 0.46, 95%CI 0.43\u20130.49; inappropriate: OR 0.51, 95%CI 0.42\u20130.62; exceptional: OR 0.26, 95%CI 0.08\u20130.84). Heterogeneity was substantial (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      0\u201396%), limiting precision.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pharmacist-led interventions are associated with improved prescribing process indicators in China. However, the evidence is limited by few RCTs, predominance of NRSIs with moderate\/high bias, and high heterogeneity. Findings are exploratory and hypothesis-generating. High-quality RCTs with patient-centered outcomes are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1860119","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:29:38Z","timestamp":1781879378000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of pharmaceutical care interventions amid pharmacist role transformation in China: a meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Pengyu","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Education, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Geng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Ninth Medical Center of PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1093\/ajhp\/47.3.533","article-title":"Opportunities and responsibilities in pharmaceutical care","volume":"47","author":"Hepler","year":"1990","journal-title":"Am J Hosp Pharm"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"100305","DOI":"10.1016\/j.rcsop.2023.100305","article-title":"The impact of hospital-based post-discharge pharmacist medication review on patient clinical outcomes: a systematic review","volume":"11","author":"Costello","year":"2023","journal-title":"Explor Res Clin Soc Pharm"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1339504","DOI":"10.3389\/fpubh.2024.1339504","article-title":"Current scenario and challenges of clinical pharmacists to implement pharmaceutical care in DRG\/DIP payment hospitals in China: a qualitative interview study","volume":"12","author":"Gao","year":"2024","journal-title":"Front Public Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1093\/ehjqcco\/qcae045","article-title":"The effect of pharmacist-led interventions on the appropriateness and clinical outcomes of anticoagulant therapy: a systematic review and meta-analysis","volume":"10","author":"Kefale","year":"2024","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"20420986241260169","DOI":"10.1177\/20420986241260169","article-title":"Interventions and impact of pharmacist-delivered services in perioperative setting on clinically important outcomes: a systematic review and meta-analysis","volume":"15","author":"Naseralallah","year":"2024","journal-title":"Ther Adv Drug Saf"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1725491","DOI":"10.3389\/fmed.2025.1725491","article-title":"Clinical pharmacist-led interventions and their impact on outcomes in patients with bipolar I disorder: a systematic review and meta-analysis","volume":"12","author":"Khobrani","year":"2025","journal-title":"Front Med (Lausanne)"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"614","DOI":"10.18553\/jmcp.2015.21.8.614","article-title":"Identifying the optimal role for pharmacists in care transitions: a systematic review","volume":"21","author":"Ensing","year":"2015","journal-title":"J Manag Care Spec Pharm"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1007\/s10143-025-03849-8","article-title":"Reducing medication errors in neurosurgery through clinical pharmacy interventions: a prospective observational study","volume":"48","author":"Lawson McLean","year":"2025","journal-title":"Neurosurg Rev"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"ED000142","DOI":"10.1002\/14651858.ED000142","article-title":"Updated guidance for trusted systematic reviews: a new edition of the Cochrane handbook for systematic reviews of interventions","volume":"10","author":"Cumpston","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1111\/j.0006-341x.2000.00455.x","article-title":"Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis","volume":"56","author":"Duval","year":"2000","journal-title":"Biometrics"},{"key":"ref14","first-page":"219","article-title":"Analysis of the effect of pharmacist intervention on antimicrobial agents during pharmacy prescription dispensing","volume":"12","author":"Chen","year":"2018","journal-title":"Chin J Mod Drug Appl"},{"key":"ref15","first-page":"191","article-title":"Analysis of the effect of pharmacist intervention on antimicrobial agents during pharmacy prescription dispensing","volume":"18","author":"Zong","year":"2018","journal-title":"World Latest Med Inf Dig"},{"key":"ref16","first-page":"185","article-title":"Analysis of the practical effect of pharmacist intervention on antimicrobial agents in pharmacy prescription dispensing","volume":"7","author":"Zhou","year":"2019","journal-title":"Cardiovasc Dis J Integr Tradit Chin West Med (Electron)"},{"key":"ref17","first-page":"217","article-title":"Observation of the effect of pharmacist intervention on the rationality of antimicrobial use in pharmacy prescription dispensing","volume":"19","author":"Gao","year":"2019","journal-title":"World Latest Med Inf Dig."},{"key":"ref18","first-page":"1748","article-title":"Impact of pharmacist participation in prescription management on rational use and safety of antimicrobials in outpatient clinics of a primary hospital","volume":"17","author":"Hu","year":"2020","journal-title":"Anti-infect Pharm"},{"key":"ref19","first-page":"144","article-title":"Brief analysis of the role of pharmacist intervention on antimicrobial agents in pharmacy prescription dispensing","volume":"13","author":"Guo","year":"2018","journal-title":"Chin Prac Med"},{"key":"ref20","first-page":"186","article-title":"Brief analysis of the role of pharmacist intervention on antimicrobial agents in pharmacy prescription dispensing","volume":"13","author":"Wu","year":"2018","journal-title":"Chin Prac Med"},{"key":"ref21","first-page":"99","article-title":"Study on the effect of pharmacist intervention on antimicrobial use in pharmacy prescription dispensing","volume":"14","author":"Liao","year":"2019","journal-title":"Chin Prac Med"},{"key":"ref22","first-page":"172","article-title":"The role of pharmacist intervention on antimicrobial agents during pharmacy prescription dispensing","volume":"10","author":"Zhang","year":"2015","journal-title":"Chin Prac Med"},{"key":"ref23","first-page":"99","article-title":"Impact of pharmacist participation in prescription management on rational use and safety of antimicrobials in outpatient clinics","volume":"8","author":"Wang","year":"2022","journal-title":"Smart Health"},{"key":"ref24","first-page":"84","article-title":"Application value of pharmacist intervention on antimicrobial agents in pharmacy prescription dispensing","volume":"12","author":"Deng","year":"2019","journal-title":"J Clin Ration Drug Use"},{"key":"ref25","first-page":"217","article-title":"Analysis of the role of pharmacist intervention on antimicrobial agents in pharmacy prescription dispensing","volume":"19","author":"Wang","year":"2019","journal-title":"World Latest Med Inf Dig"},{"key":"ref26","first-page":"12","article-title":"The role of pharmacist intervention on antimicrobial agents in pharmacy prescription dispensing","volume":"35","author":"Geng","year":"2019","journal-title":"Chin Community Dr"},{"key":"ref27","first-page":"166","article-title":"The role of pharmacist intervention on antimicrobial agents in pharmacy prescription dispensing","volume":"6","author":"Jia","year":"2019","journal-title":"J Clin Med Lit (Electron)"},{"key":"ref28","first-page":"71","article-title":"Effect of pharmacist intervention on rational use of antimicrobials in pharmacy prescription dispensing","volume":"32","author":"Chen","year":"2019","journal-title":"Med Equip"},{"key":"ref29","first-page":"96","article-title":"Effect of pharmacist intervention on rationality of antimicrobial use in pharmacy prescription dispensing","volume":"30","author":"Yang","year":"2018","journal-title":"Chin J Public Health Med"},{"key":"ref30","first-page":"130","article-title":"The role of clinical pharmacists in the management of clinical antimicrobial use","volume":"17","author":"Zou","year":"2020","journal-title":"North Pharm"},{"key":"ref31","first-page":"66","article-title":"Impact of pharmacist guidance on clinical antimicrobial use in pharmacy prescription dispensing","volume":"33","author":"Zhuo","year":"2023","journal-title":"Shenzhen J Integr Tradit Chin West Med"},{"key":"ref32","first-page":"254","article-title":"Analysis of the role of pharmacist intervention on antimicrobial agents in pharmacy prescription dispensing","volume":"19","author":"Tang","year":"2019","journal-title":"World Latest Med Inf Dig"},{"key":"ref33","first-page":"228","article-title":"Exploration of the role of pharmacist intervention on antimicrobial agents in pharmacy prescription dispensing","volume":"19","author":"Geng","year":"2019","journal-title":"World Latest Med Inf Dig"},{"key":"ref34","first-page":"256","article-title":"The role of pharmacist intervention on antimicrobial agents in pharmacy prescription dispensing","volume":"19","author":"Yao","year":"2019","journal-title":"World Latest Med Inf Dig"},{"key":"ref35","first-page":"9","article-title":"Effect of targeted pharmacist intervention prescription review model on rational drug use in pharmacy intravenous admixture service centers","volume":"41","author":"Cai","year":"2025","journal-title":"Chin Community Dr"},{"key":"ref36","first-page":"119","article-title":"Analysis of pharmacist intervention on the use of Chinese patent medicine injections in intravenous drug configuration center","volume":"12","author":"Gu","year":"2019","journal-title":"J Clin Ration Drug Use"},{"key":"ref37","first-page":"145","article-title":"The role of pharmacist intervention in reducing irrational prescriptions in pharmacy intravenous admixture service centers","volume":"14","author":"Che","year":"2021","journal-title":"J Clin Ration Drug Use"},{"key":"ref38","first-page":"36","article-title":"Application effect of pharmacist intervention on rational drug use in pharmacy intravenous admixture service centers","volume":"22","author":"Huang","year":"2024","journal-title":"Famous Doctor"},{"key":"ref39","first-page":"231","article-title":"Application of pharmacist intervention on rational drug use in pharmacy intravenous admixture service centers","volume":"14","author":"Zhang","year":"2021","journal-title":"J Clin Ration Drug Use"},{"key":"ref40","first-page":"2063","article-title":"Effect of clinical pharmacist review and intervention on irrational outpatient prescriptions","volume":"43","author":"Zhu","year":"2021","journal-title":"Hebei Med J"},{"key":"ref41","first-page":"177","article-title":"Practical effect analysis of strengthening pharmacist review and intervention on irrational prescriptions in outpatient pharmacy","volume":"32","author":"Yang","year":"2020","journal-title":"Strait Pharm J"},{"key":"ref42","first-page":"189","article-title":"Pharmaceutical intervention analysis of irrational combined use of Chinese and Western medicines by outpatient pharmacists","volume":"15","author":"Zhu","year":"2018","journal-title":"North Pharm."},{"key":"ref43","first-page":"187","article-title":"Intervention effect analysis of pharmacist participation in outpatient pharmacy prescription management on irrational prescriptions","volume":"16","author":"Liu","year":"2022","journal-title":"Chin J Mod Drug Appl"},{"key":"ref44","first-page":"226","article-title":"Observation of intervention effect of pharmacists on irrational prescriptions in outpatient pharmacy","volume":"10","author":"Yang","year":"2020","journal-title":"Med Front"},{"key":"ref45","first-page":"249","article-title":"Effect of pharmacist pharmaceutical care based on actual work on promoting rational drug use in outpatient pharmacy","volume":"31","author":"Zhong","year":"2019","journal-title":"Strait Pharm J"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1093\/ijpp\/riag006","article-title":"Role of pharmacy education and pharmacy practice in developing pharmacists as researchers in Austria","volume":"34","author":"Rose","year":"2026","journal-title":"Int J Pharm Pract"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1093\/fampra\/cmac150","article-title":"Audit and feedback interventions involving pharmacists to influence prescribing behaviour in general practice: a systematic review and meta-analysis","volume":"40","author":"Carter","year":"2023","journal-title":"Fam Pract"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/14651858.CD013102","article-title":"Pharmacist services for non-hospitalised patients","volume":"2018","author":"de Barra","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1177\/00048674211048410","article-title":"Pharmacist-led interventions for people living with severe and persistent mental illness: a systematic review","volume":"56","author":"Ng","year":"2022","journal-title":"Aust N Z J Psychiatry"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"e37764","DOI":"10.1016\/j.heliyon.2024.e37764","article-title":"Pharmacist-led interventions in addressing improper disposal practices of unused and expired household medication: a systematic review","volume":"10","author":"Alfian","year":"2024","journal-title":"Heliyon"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"e108","DOI":"10.1017\/ash.2024.349","article-title":"Pharmacist-led antimicrobial stewardship at transitions of care from inpatient hospital to home: a scoping review","volume":"4","author":"Danchuk-Lauzon","year":"2024","journal-title":"Antimicrob Steward Healthc Epidemiol"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"q1170","DOI":"10.1136\/bmj.q1170","article-title":"Antimicrobial stewardship","volume":"5","author":"Powers","year":"2024","journal-title":"BMJ"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1055\/s-0041-1740977","article-title":"Antimicrobial stewardship in the ICU","volume":"43","author":"Murphy","year":"2022","journal-title":"Semin Respir Crit Care Med"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1177\/09514848231194846","article-title":"Service design for the transformation of healthcare systems: a systematic review of literature","volume":"37","author":"Vaz","year":"2024","journal-title":"Health Serv Manag Res"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1097\/JHM-D-23-00210","article-title":"Leadership to accelerate healthcare's digital transformation: evidence from 33 health systems","volume":"69","author":"Lemak","year":"2024","journal-title":"J Healthc Manag"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s13012-024-01357-9","article-title":"Generative AI in healthcare: an implementation science informed translational path on application, integration and governance","volume":"19","author":"Reddy","year":"2024","journal-title":"Implement Sci"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"4054","DOI":"10.1161\/STROKEAHA.121.033971","article-title":"Implementation science","volume":"52","author":"Williams","year":"2021","journal-title":"Stroke"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1093\/ijpp\/riad037","article-title":"Pharmacist interventions in medication adherence in patients with mental health disorders: a scoping review","volume":"31","author":"Syrnyk","year":"2023","journal-title":"Int J Pharm Pract"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"102058","DOI":"10.1016\/j.japh.2024.102058","article-title":"Effect of pharmacist interventions on the management of overweight and obesity: a systematic review","volume":"64","author":"Alhomoud","year":"2003","journal-title":"J Am Pharm Assoc"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1016\/j.sapharm.2023.04.124","article-title":"Community pharmacist-led interventions for patients with type 2 diabetes in low-income and middle-income countries: a scoping review","volume":"19","author":"Cahyaningsih","year":"2023","journal-title":"Res Social Adm Pharm"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1860119\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:29:42Z","timestamp":1781879382000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1860119\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,19]]},"references-count":60,"alternative-id":["10.3389\/fpubh.2026.1860119"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1860119","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,19]]},"article-number":"1860119"}}