Evidence map›Paper›PMID 25347723›Full record

Trial reportScandinavian journal of primary health care2014

Effects of a pharmacist-led structured medication review in primary care on drug-related problems and hospital admission rates: a randomized controlled trial.

Cecilia Lenander, Birgitta Elfsson, Birgitta Danielsson, Patrik Midlöv, Jan Hasselström

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Scandinavian journal of primary health care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03689049 (SPIDER), which is not on this map. Cited by 67 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 18 pooled it
3.9field-weighted citation impact, top 7% of its field
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.

NCT03689049 naactive not recruitingnot on this mapstarted 2018, after this paper: background citation

SPIDER: A Structured Process Informed by Data, Evidence and Research - A Research and Quality Improvement Collaboration Supporting Practices in Improving Care for Complex Elderly Patients

TypeinterventionalSponsorUniversity of Toronto Practice Based Research NetworkRan2018 to 2027Enrolled104ConditionsPolypharmacy, Inappropriate Prescribing, Aged, Primary Health CareArmsSPIDER, Usual Care
3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 18 syntheses or guidelines pooled it, 142 citations in OpenAlex.

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  10. Impact of integrating pharmacists into primary care teams on health systems indicators: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019
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  12. Pharmacist services for non-hospitalised patients.The Cochrane database of systematic reviews · 2018
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  18. Ambulatory Medication Safety in Primary Care: A Systematic Review.Journal of the American Board of Family Medicine : JABFM
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7 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

5 authors at 4 institutions in 1 country.

Cecilia LenanderDepartment of Clinical Sciences in Malmö, Lund University , Malmö , Sweden.
Birgitta Elfsson
Birgitta Danielsson
Patrik Midlöv
Jan Hasselström
Lund University · SEKarolinska Institutet · SEStockholm County Council · SEStockholm South General Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine whether a pharmacist-led medications review in primary care reduces the number of drugs and the number of drug-related problems.

designProspective randomized controlled trial.

settingLiljeholmen Primary Care Centre, Stockholm, Sweden. SUBJECTS: 209 patients aged ≥ 65 years with five or more different medications. Intervention. Patients answered a questionnaire regarding medications. The pharmacist reviewed all medications (prescription, non-prescription, and herbal) regarding recommendations and renal impairment, giving advice to patients and GPs. Each patient met the pharmacist before seeing their GP. Control patients received their usual care.

main outcome measuresDrug-related problems and number of drugs. Secondary outcomes included health care utilization and self-rated health during 12 months of follow-up.

resultsNo significant difference was seen when comparing change in drug-related problems between the groups. However, a significant decrease in drug-related problems was observed in the intervention group (from 1.73 per patient at baseline to 1.31 at follow-up, p < 0.05). The change in number of drugs was more pronounced in the intervention group (p < 0.046). Intervention group patients were not admitted to hospital on fewer occasions or for fewer days, and there was no significant difference between the two groups regarding utilization of primary care during follow-up. Self-rated health remained unchanged in the intervention group, whereas a drop (p < 0.02) was reported in the control group. This resulted in a significant difference in change in self-rated health between the groups (p < 0.047).

conclusionsThe addition of a skilled pharmacist to the primary care team may contribute to reductions in numbers of drugs and maintenance of self-rated health in elderly patients with polypharmacy.

Indexed as

Drug Utilization ReviewPharmacistsAgedAged, 80 and overDrug PrescriptionsDrug-Related Side Effects and Adverse ReactionsFemaleHumansLongitudinal StudiesMalePatient AdmissionPharmaceutical ServicesPolypharmacyPrimary Health CareProspective StudiesSwedenDrug-related problemselderlygeneral practicemedication reviewpharmacistprimary careSweden

Identifiers

PMID25347723
PMCPMC4278387
OpenAlexW2097206036

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.