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VICTOR COHEN, PHARM.D., BCPS, CGP, is Assistant Professor of Pharmacy Practice, Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Brooklyn, NY, and Clinical Pharmacy Manager, Department of Emergency Medicine and Department of Pharmaceutical Services, Maimonides Medical Center, Brooklyn. Samantha P. JELLINEK, PHARM.D., BCPS, CGP, is Clinical Pharmacy Manager for Medication Reconciliation and Safety, Department of Pharmaceutical Services; AMIE HATCH, PHARM.D., is Pharmacy Practice Resident, Department of Pharmaceutical Services; and SERGEY MOTOV, M.D., is Attending Physician, Department of Emergency Medicine, Maimonides Medical Center.

Address correspondence to Dr. Cohen at the Department of Pharmaceutical Services, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219 (vcohen{at}maimonidesmed.org). The authors have declared no potential conflicts of interest.

Purpose. A systematic literature review was conducted to ascertain the scope of involvement of clinical pharmacists in the emergency department (ED); summarize economic, humanistic, and clinical outcomes data; describe current limitations of these data; and identify areas for future research. Methods. A search of MEDLINE, The Cochrane Library, International Pharmaceutical Abstracts, and CINAHL Plus databases was conducted. Articles were included in this review if the title and abstract indicated that the article’s content addressed the scope of involvement of pharmacists in the ED or pharmacist interventions in the ED and their associated outcomes, such as humanistic outcomes, cost avoidance, or improved quality. Qualitative analyses were conducted to characterize pharmacists’ activities and effects in the ED. Results. Of the 533 returned citations, only 17 met the inclusion criteria. Each provided a description of clinical pharmacy services at 12 different institutions. Descriptions of these institutions and job responsibilities of the ED pharmacists are described. Six studies reported information about pharmacist interventions, including the number and types of interventions, time spent per intervention, and acceptance rate of interventions. Four studies reported cost-related outcomes data. Conclusion. A review of the literature revealed that pharmacists have been involved in the ED for decades. Services provided by pharmacists in the ED included traditional clinical pharmacy services, responding to medical emergencies, providing consultations on medication issues, identifying and reducing medication errors, and conducting medication histories at hospital admission. Some services were shown to be cost saving or cost avoiding. Index terms: Clinical pharmacists; Clinical pharmacy; Economics; Errors, medication; Hospitals; Outcomes; Pharmaceutical services