Trial reportPloS one2014
The effects of pharmacist intervention on emergency department visits in patients 80 years and older: subgroup analyses by number of prescribed drugs and appropriate prescribing.
Trial report in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 5 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
12 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Medication review in hospitalised patients to reduce morbidity and mortality.The Cochrane database of systematic reviews · 2023Pooled it
- Interventions to improve the appropriate use of polypharmacy for older people.The Cochrane database of systematic reviews · 2018Pooled it
- Professional, structural and organisational interventions in primary care for reducing medication errors.The Cochrane database of systematic reviews · 2017Pooled it
- A Systematic Review of Opioid and Benzodiazepine Misuse in Older Adults.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2016Pooled it
- The impact of pharmaceutical care interventions for medication underuse in older people: a systematic review and meta-analysis.British journal of clinical pharmacology · 2015Pooled it
- Effect of pharmacist-led inhaler technique assessment service on readmissions in hospitalized COPD patients: a randomized, controlled pilot study.BMC pulmonary medicine · 2022Trial
- The effects of a pharmacist-led medication review in a nursing home: A randomized controlled trial.Medicine · 2021Trial
- Effect of medicines management versus standard care on readmissions in multimorbid patients: a randomised controlled trial.BMJ open · 2020Trial
- Drug-related problems and medication reviews among old people with dementia.BMC pharmacology & toxicology · 2017Trial
- Prevalence and risk factors of drug-related hospitalizations in multimorbid patients admitted to an internal medicine ward.PloS one · 2019Observational
- Characterisation of Drug-Related Problems and Associated Factors at a Clinical Pharmacist Service-Naïve Hospital in Northern Sweden.Drugs - real world outcomes · 2017Article
- Potentially inappropriate prescribing and associated factors in elderly patients at hospital discharge in Brazil: a cross-sectional study.International journal of clinical pharmacy · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical pharmacist interventions have been shown to have positive effect on occurrence of drug-related issues as well as on clinical outcomes. However, evidence about which patients benefiting most from the interventions is limited. We aimed to explore whether pharmacist intervention is equally effective in preventing emergency department (ED) visits in patients with few or many prescribed drugs and in those with different levels of inappropriate prescribing.
methodsPatient and outcome data from a randomized controlled trial exploring the clinical effects of a ward-based pharmacist intervention in patients, 80 years and older, were used. The patients were divided into subgroups according to the number of prescribed drugs (<5 or ≥5 drugs) and the level of inappropriate prescribing [using the Screening Tool Of Older People's potentially inappropriate Prescriptions (STOPP) and the Screening Tool to Alert doctors to Right Treatment (START) with a score of ≥2 (STOPP) and ≥1 (START) as cutoff points]. The effect of the intervention on the number of times the different subgroups visited the ED was analyzed.
resultsThe pharmacist intervention was more effective with respect to the number of subsequent ED visits in patients taking <5 drugs on admission than in those taking ≥5 drugs. The rate ratio (RR) for a subsequent ED visit was 0.22 [95% confidence interval (CI) 0.09-0.52] for <5 drugs and 0.70 (95% CI 0.47-1.04) for ≥5 drugs (p = 0.02 for the interaction). The effect of intervention did not differ between patients with high or low STOPP or START scores.
conclusionIn this exploratory study, the pharmacist intervention appeared to be more effective in preventing visits to the ED for patients who were taking fewer drugs before the intervention. Our analysis of STOPP and START scores indicated that the level of inappropriate prescribing on admission had no effect on the outcomes of intervention with respect to ED visits.
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