Table 8, Clinical evidence summary: Community pharmacist based within a community pharmacy - Emergency and acute medical care in over 16s: service delivery and organisation

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Table 8Clinical evidence summary: Community pharmacist based within a community pharmacy

Outcomes	No of Participants (studies) Follow up	Quality of the evidence (GRADE)	Relative effect (95% CI)	Anticipated absolute effects
Outcomes	No of Participants (studies) Follow up	Quality of the evidence (GRADE)	Relative effect (95% CI)	Risk with Control	Risk difference with Community pharmacist @ pharmacy versus usual care (95% CI)
Mortality	2989 (6 studies) 6 months	⊕⊝⊝⊝ VERY LOW^a^,^b^,^c due to risk of bias^, inconsistency^, imprecision	RR 0.69 (0.46 to 1.02)	Moderate
Mortality	2989 (6 studies) 6 months		RR 0.69 (0.46 to 1.02)	32 per 1000	10 fewer per 1000 (from 17 fewer to 1 more)
ED presentations	2413 (7 studies) 3 months	⊕⊝⊝⊝ LOW^a^,^c due to risk of bias^, imprecision	RR 0.63 (0.53 to 0.76)	Moderate
ED presentations	2413 (7 studies) 3 months	⊕⊝⊝⊝ LOW^a^,^c due to risk of bias^, imprecision	RR 0.63 (0.53 to 0.76)	93 per 1000	34 fewer per 1000 (from 22 fewer to 44 fewer)
ED presentations	314 (1 study) 12 months	⊕⊕⊝⊝ LOW^a due to risk of bias		The mean ED presentations in the control groups was 2.68 days	The mean ED presentations in the intervention groups was 0.52 lower (1.43 lower to 0.39 higher)
Hospital admissions	1267 (7 studies) 3 months	⊕⊝⊝⊝ VERY LOW^a^,^b^,^c due to risk of bias^, inconsistency^, imprecision	RR 0.92 (0.56 to 1.49)	Moderate
Hospital admissions	1267 (7 studies) 3 months		RR 0.92 (0.56 to 1.49)	93 per 1000	7 fewer per 1000 (from 41 fewer to 46 more)
Mean number of hospitalisations	1612 (2 study) 6-12 months	⊕⊕⊕⊝ MODERATE^a due to risk of bias		The mean number of hospitalisations in the control groups was 0.08 admissions	The mean number of hospitalisations in the intervention groups was 0.02 lower (0.05 lower to 0.1 higher)
GP visits	330 (2 studies) 2-3 months	⊕⊝⊝⊝ VERY LOW^a^,^b^,^c due to risk of bias^, inconsistency^, imprecision	RR 0.6 (0.17 to 2.06)	Moderate
GP visits	330 (2 studies) 2-3 months		RR 0.6 (0.17 to 2.06)	797 per 1000	319 fewer per 1000 (from 662 fewer to 845 more)

(a): Downgraded by 1 increment if the majority of the evidence was at high risk of bias^, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias.
(b): Downgraded by 1 or 2 increments because: the point estimate varies widely across studies^, unexplained by subgroup analysis.
(c): Downgraded by 1 increment if the confidence interval crossed 1 MID or by 2 increments if the confidence interval crossed both MIDs.

From: Chapter 10, Community-based pharmacists

Emergency and acute medical care in over 16s: service delivery and organisation.

NICE Guideline, No. 94.

National Guideline Centre (UK).

London: National Institute for Health and Care Excellence (NICE); 2018 Mar.

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