Critical care pharmacists in intensive care units: A meta-analysis of their impact on mortality and adverse drug events

Introduction: Critical care pharmacists (CCPs) are increasingly integrated into intensive care unit (ICU) teams to enhance medication safety and improve outcomes. However, their effect on mortality and adverse drug events (ADEs) remains inadequately studied. Objective: This study aimed to evaluate the impact of CCP involvement in ICU care on patient mortality and ADEs. Methods: A comprehensive systematic review and meta-analysis were performed, encompassing studies published through January 2025. The literature search was conducted in multiple databases, such as PubMed, Embase, and the Cochrane Library. Results: A total of 16 eligible studies were identified, collectively involving 37,925 ICU patients. To evaluate outcomes, odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated utilizing either fixed-effects or random-effects models, depending on heterogeneity levels. Patients in ICUs with CCPs experienced significantly reduced mortality (OR: 0.72; 95% CI: 0.56 – 0.92; p=0.01) and fewer ADEs (OR: 0.39; 95% CI: 0.21 – 0.70; p=0.002) compared to controls. Despite notable heterogeneity, findings were consistent in sensitivity analyses. No significant publication bias was detected. Conclusion: The inclusion of CCPs in ICU teams is associated with lower mortality and fewer ADEs. These findings support expanding the role of pharmacists in critical care settings.