The Impact of Pharmacist Led Interventions on Medication Safety and Clinical Outcomes in Specialized Outpatient Settings: A Scoping Review

Abstract

This scoping review maps the existing evidence on pharmacist-led interventions in specialized outpatient settings to synthesize their impact on medication safety and clinical outcomes. Conducted in accordance with JBI methodology and PRISMA ScR guidelines, a systematic search of PubMed, Scopus, Embase, and CINAHL (2012-2023) identified relevant studies. Data were extracted on study design, setting, intervention type, and outcomes.The review synthesized evidence from diverse settings including rheumatology, geriatric oncology, obstetrics and gynaecology, transplant care, and primary care. Pharmacist-led interventions such as medication reconciliation, comprehensive medication review, prescribing error interception, and targeted deprescribing of high-risk medications (HRMs) consistently demonstrated significant benefits. Key findings included reductions in prescribing errors (up to 9.2% of prescriptions intercepted), deprescribing of potentially inappropriate medications (PIMs) and HRMs (e.g., from 10.9% to 1.9%), and high rates of accepted clinical interventions (up to 92.4%). These activities led to optimized therapeutic regimens and mitigated drug-related harm, with interventions preventing major or fatal outcomes in specific high-risk populations. Pharmacist integration into outpatient multidisciplinary teams is a powerful strategy for enhancing medication safety and clinical outcomes. The evidence supports a shift from the pharmacist's traditional dispensing role to that of a clinical gatekeeper and therapeutic manager. Future efforts should focus on standardizing outcome measures, evaluating cost-effectiveness, developing scalable implementation models, and integrating pharmacists into learning health systems to sustain and expand their impact.