Medication review in hospitalised patients to reduce morbidity and mortality

Christensen, Mikkel B.; Lundh, Andreas

doi:10.1002/14651858.cd008986.pub2

Cited by 127 publications

(157 citation statements)

References 68 publications

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“…Outcomes reported in trials of medication review in older patients review [12,15,16,21]. However, our results suggest that the choice to perform meta-analyses on these outcomes are probably related to the high proportion of studies reporting these outcomes as opposed to their relevance.…”

Section: Figurementioning

confidence: 83%

“…Numerous randomized controlled trials (RCT) have been performed to evaluate the impact of medication review on clinical, patient-reported and economic outcomes. Several systematic reviews and meta-analyses have therefore been conducted to summarize the effectiveness of medication review in various settings [7,8,[10][11][12][13][14][15][16][17][18][19][20]. However, the heterogeneity of outcomes reported in the RCTs has limited the quality of the conclusions of these systematic reviews.…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set

Beuscart

Pont

Thevelin

et al. 2017

Brit J Clinical Pharma

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SummaryAim: Medication review has been advocated as one of the measures to tackle the challenge of polypharmacy in older patients, yet there is no consensus on how best to evaluate its efficacy. This study aimed to assess outcome reporting in trials of medication review in older patients. Methods:Randomized controlled trials (RCTs), prospective studies and RCT protocols involving medication review performed in patients aged 65 years or older in any setting of care were identified from: (1) a recent systematic review; (2) RCT registries of ongoing studies; (3) the Cochrane library. The type, definition, and frequency of all outcomes reported were extracted independently by two researchers.Results: 47 RCTs or prospective published studies and 32 RCT protocols were identified. A total of 327 distinct outcomes were identified in the 47 published studies. Merely one fifth (21%) of the studies evaluated the impact of medication reviews on adverse events like adverse drug reactions or drug-related hospital admissions. Most of the outcomes were related to medication use (n=114, 35%) and healthcare use (n=74, 23%). Very few outcomes were patient related outcomes (n=24, 7%). A total of 248 distinct outcomes were identified in the 32 RCT protocols. Overall, the number of outcomes and the number and type of health domains covered by the outcomes varied largely. Conclusion:Outcome reporting from RCTs concerning medication review in older patients is heterogeneous. This review highlights the need for a standardised core outcome set for medication review in older patients, to improve outcome reporting and evidence synthesis. This article is

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Section: Figurementioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set

Beuscart

Pont

Thevelin

et al. 2017

Brit J Clinical Pharma

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“…Medication reconciliation should be implemented during patient admission, transfer and discharge to reduce medication errors, decrease avoidable morbidity and improve patient safety. 1 Patients, especially the elderly, might not regularly seek care at the same facility, which could result in taking duplicate or inappropriate medications. 2 Elderly patients may practice hospital shopping behaviour, which results in repeatedly visiting hospitals for the same disease, and for the same medications with the same pharmacological classification.…”

Section: Introductionmentioning

confidence: 99%

“…The impact of medication reconciliation by healthcare professional on inpatient outcomes has been well demonstrated in some countries. 1 In the Netherlands, medication reconciliation by pharmacists at intensive care unit transfers led to a significant decrease medication transfer errors and a cost-effective reduction in potential harm. 9 In England, the addition of pharmacists to healthcare teams would reduce morbidity and health care costs.…”

Section: Introductionmentioning

confidence: 99%

The impact of a medication reconciliation programme at geriatric hospital admission: A pre‐/postintervention study

Hung

Chen

et al. 2019

Brit J Clinical Pharma

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Aims The aim of this study was to improve medication reconciliation and reduce the occurrence of duplicate prescriptions by pharmacists and physicians within 72 hours of hospital admission using an intelligent prescription system combined with the National Health Insurance PharmaCloud system to integrate the database with the medical institution computerized physician order entry (CPOE) system. Methods This 2‐year intervention study was implemented in the geriatric ward of a hospital in Taiwan. We developed an integrated CPOE system linked with the PharmaCloud database and established an electronic platform for coordinated communication with all healthcare professionals. Patients provided written informed consent to access their PharmaCloud records. We compared the intervention effectiveness within 72 hours of admission for improvement in pharmacist medication reconciliation, increased at‐home medications documentation and decreased costs from duplicated at‐home prescriptions. Results The medication reconciliation rate within 72 hours of admission increased from 44.0% preintervention to 86.8% postintervention (relative risk = 1.97, 95% confidence interval [CI]: 1.69–2.31; P < .001). The monthly average of patients who brought and took home medications documented in the CPOE system during hospitalization increased by 7.54 (95% CI 5.58–20.49, P = .22). The monthly average of home medications documented increased by 102.52 (95% CI 38.44–166.60; P = .01). Savings on the monthly average prescription expenditures of at‐home medication increased by US$ 2,795.52 (95% CI US$1310.41–4280.63; P < .01). Conclusion Integrating medication data from PharmaCloud to the hospital's medical chart system improved pharmacist medication reconciliation, which decreased duplicated medications and reduced in‐hospital medication costs.

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“…Interventions focused on patient education related to pharmacological therapy may increase medication adherence and decrease morbidity [10]. Several interventions for improving adherence have been tested in clinical studies, including motivational and behavior strategies, simplification of dosing regimens, unit dose packaging, educational counseling, refill reminders and self-monitoring [11-16].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of pharmaceutical care at discharge in the emergency department: study protocol of a randomized controlled trial

Kuhmmer

Lima

Ribeiro

et al. 2015

Trials

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BackgroundPatient education on pharmacological therapy may increase medication adherence and decrease hospitalizations. Our aim is to evaluate the effectiveness of pharmaceutical care at emergency department discharge in patients with hypertension and/or diabetes.Methods/designThis is a randomized controlled trial. Participants will be recruited from a public emergency department at Restinga district in Porto Alegre, southern Brazil. A total of 380 patients will be randomly assigned into 2 groups at the moment of emergency department discharge after receiving medical orientations: an intervention group, consisting of a structured individual counseling session by a pharmacist in addition to written orientations, or a control group, consisting only of written information about the disease. Outcomes will be assessed in an ambulatory visit 2 months after the randomization. The primary outcome is the proportion of patients with high medication adherence assessed using the Morisky-Green Test and the Brief Medication Questionnaire. The secondary outcomes are reduction of blood pressure, glycated hemoglobin, fasting plasma glucose, quality of life and number of visits to the emergency department.DiscussionPharmaceutical care interventions have shown to be feasible and effective in increasing medication adherence in both hospital outpatient and community pharmacy settings. However, there have been no previous assessments of the effectiveness of pharmacy care interventions initiated in patients discharged from emergency departments. Our hypothesis is that pharmaceutical counseling is also effective in this population.Trial registrationClinicalTrials.gov registration number: NCT01978925 (11 November 2013) and Brazilian Registry of Clinical Trials U1111-1149-8922 (5 November 2013).Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-0579-3) contains supplementary material, which is available to authorized users.

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Medication review in hospitalised patients to reduce morbidity and mortality

Cited by 127 publications

References 68 publications

A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set

A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set

The impact of a medication reconciliation programme at geriatric hospital admission: A pre‐/postintervention study

Effectiveness of pharmaceutical care at discharge in the emergency department: study protocol of a randomized controlled trial

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