Evidence map›Paper›PMID 23408163›Full record

Trial reportDrugs & aging2013

Improving the quality of pharmacotherapy in elderly primary care patients through medication reviews: a randomised controlled study.

Veronica Milos, Eva Rekman, Åsa Bondesson, Tommy Eriksson, Ulf Jakobsson, Tommy Westerlund, Patrik Midlöv

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Drugs & aging, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

74 citing papers in PubMed, 12 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pharmacist services for non-hospitalised patients.The Cochrane database of systematic reviews · 2018
    Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Interventions to optimise prescribing for older people in care homes.The Cochrane database of systematic reviews · 2016
    Pooled it
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Article
  18. Article
  19. Article
  20. Article

14 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Veronica MilosLaröd Health Care Centre, Helsingborg, Sweden. veronica.milos@med.lu.se
Eva Rekman
Åsa Bondesson
Tommy Eriksson
Ulf Jakobsson
Tommy Westerlund
Patrik Midlöv

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPolypharmacy in the Swedish elderly population is currently a prioritised area of research with a focus on reducing the use of potentially inappropriate medications (PIMs). Multi-professional interventions have previously been tested for their ability to improve drug therapy in frail elderly patients.

objectiveThis study aimed to assess a structured model for pharmacist-led medication reviews in primary health care in southern Sweden and to measure its effects on numbers of patients with PIMs (using the definition of the Swedish National Board of Health and Welfare) using ≥10 drugs and using ≥3 psychotropics.

methodsThis study was a randomised controlled clinical trial performed in a group of patients aged ≥75 years and living in nursing homes or the community and receiving municipal health care. Medication reviews were performed by trained clinical pharmacists based on nurse-initiated symptom assessments with team-based or distance feedback to the physician. Data were collected from the patients' electronic medication lists and medical records at baseline and 2 months after the medication review.

resultsA total of 369 patients were included: 182 in the intervention group and 187 in the control group. One-third of the patients in both groups had at least one PIM at baseline. Two months after the medication reviews, the number of intervention group patients with at least one PIM and the number of intervention group patients using ten or more drugs had decreased (p = 0.007 and p = 0.001, respectively), while there were no statistically significant changes in the control patients. No changes were seen in the number of patients using three or more psychotropic drugs, although the dosages of these drugs tended to decrease. Drug-related problems (DRPs) were identified in 93 % of the 182 patients in the intervention group. In total, there were 431 DRPs in the intervention group (a mean of 2.5 DRPs per patient, range 0-9, SD 1.5 at 95 % CI) and 16 % of the DRPs were related to PIMs.

conclusionsMedication reviews involving pharmacists in primary health care appear to be a feasible method to reduce the number of patients with PIMs, thus improving the quality of pharmacotherapy in elderly patients.

Indexed as

PolypharmacyAgedAged, 80 and overFemaleHealth ServicesHumansInappropriate PrescribingMalePharmacistsPrimary Health CareQuality Control

Identifiers

PMID23408163

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.