There were five RCTs (1,035 participants) including two cluster RCTs. Follow-up ranged from three to 12 months. Adequate methods of randomisation were used in three RCTs, one RCT described an adequate method of allocation concealment and two RCTs had blinded outcome assessment.
At three months there was a statistically significant reduction in pain intensity for patients who received pharmacist-led medication review compared with the control group (SMD -0.37, 95% CI -0.58 to -0.16; three RCTs; Ι²=0%) corresponding to a 0.83 point (95% CI -1.28 to -0.36) reduction on an 11-point numerical rating scale. The difference in pain intensity between groups was still statistically significant at six months (SMD -0.31, 95% CI -0.53 to -0.09; two RCTs, Ι²=39%) corresponding to a 0.7 point (-1.19 to -0.20) reduction on an 11-point numerical rating scale.
There was a statistically significant improvement in physical functioning for patients who received pharmacist-led medication review, compared with the control group, at three months (SMD -0.38, 95% CI -0.58 to -0.18; three RCTs; Ι²=0%) and six months (SMD -0.30, 95% CI -0.51 to -0.09; two RCTs; Ι²=33%) corresponding to a 4.84 point and 3.82 point reduction on a 69-point function subscale.
Patient satisfaction was significantly greater in the pharmacist-led medication review group than the control group (SMD -0.39, 95% CI -0.68 to -0.10; two RCTs).
Quality of life data could not be pooled and results of individual studies were inconsistent.