Strengths and limitations
Strengths: The MTM mode was established for MMD inpatients. The evaluation indexes include clinical indicators, economic outcomes, human outcomes, and the number of DRPs. The evaluation is relatively comprehensive. Meanwhile, the pharmacists will be assisted in improving their pharmaceutical service and MMD management capability, strengthening their communication with patients, improving their service enthusiasm, and reflecting on their professional value.Limitations: Clinical pharmacists delivered the intervention and assessed the outcomes, increasing the risk of biased assessment. However, the outcome was assessed using an objective measurement tool, which may have minimized the potential effects of this bias on the outcome. In the future, using third-party personnel to measure the clinical outcomes may help mitigate bias. Additionally, the overall drop-out rate in this study was 15.8%, which is slightly higher than that observed in previous pharmacy studies of patients. Due to the limited pharmacists in medical institutions, there are not enough pharmacists capable of undertaking pharmaceutical care. Older adults do not fully recognize MTMs, and long-term follow-up leads to a slightly higher rate of loss to follow-up. In the future, we will actively cooperate with community pharmacists to provide more comprehensive and long-term services to MMD patients. Finally, analyses were conducted and it was determined that the group lost to follow-up was not statistically associated with the group successfully followed up. While these analyses reduced selection bias to some extent, they may inevitably lead to biased results, for example, data on people who were missed due to deteriorating health status may have had some impact on the outcome of the intervention group. Therefore, we need larger sample sizes and better designs in the future.