Evidence map›Paper›PMID 25581134›Full record

SynthesisBritish journal of clinical pharmacology2015

The effect of early in-hospital medication review on health outcomes: a systematic review.

Corinne M Hohl, Maeve E Wickham, Boris Sobolev, Jeff J Perry, Marco L A Sivilotti, Scott Garrison, Eddy Lang, Penny Brasher, Mary M Doyle-Waters, Baljeet Brar and 3 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of clinical pharmacology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 6 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

31 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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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

13 authors.

Corinne M HohlDepartment of Emergency Medicine, The University of British Columbia, 855 West 12thAvenue, Vancouver, British Columbia, V5Z 1 M9, Canada.
Maeve E WickhamDepartment of Emergency Medicine, The University of British Columbia, 855 West 12thAvenue, Vancouver, British Columbia, V5Z 1 M9, Canada.
Boris SobolevCentre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, 900 West 10th Ave, Vancouver, British Columbia, V5Z 1 M9, Canada.
Jeff J PerryDepartment of Emergency Medicine, Faculty of Medicine, University of Ottawa, 1053 Carling Ave., E-Main Room EM-206, Box 227, Ottawa, Ontario, K1Y 4E9.
Marco L A SivilottiDepartments of Emergency Medicine, and of Biomedical & Molecular Sciences, Queen's University, c/o 76 Stuart Street, Kingston, ON, K7L 2 V7.
Scott GarrisonDepartment of Family Medicine, University of Alberta, 8215-112 Street NW, Room 1706 College Plaza, Edmonton, Alberta.
Eddy LangDepartment of Emergency Medicine, Faculty of Medicine, University of Calgary, Rockyview General Hospital, HCAC building, 7007 14th St. SW, Calgary, AB, T2V 1P9.
Penny BrasherCentre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, 900 West 10th Ave, Vancouver, British Columbia, V5Z 1 M9, Canada.
Mary M Doyle-WatersCentre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, 900 West 10th Ave, Vancouver, British Columbia, V5Z 1 M9, Canada.
Baljeet BrarDepartment of Emergency Medicine, The University of British Columbia, 855 West 12thAvenue, Vancouver, British Columbia, V5Z 1 M9, Canada.
Brian H RoweDepartment of Emergency Medicine, Faculty of Medicine and Dentistry and School of Public Health, University of Alberta, 1G1.42 Walter Mackenzie Building, Edmonton, AB, T6G 2B7.
Joel LexchinSchool of Health Policy and Management, York University, 4700 Keele St., Toronto, ON, M3J 1P3.
Richard HollandPublic Health Medicine, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsAdverse drug events are an important cause of emergency department visits, unplanned admissions and prolonged hospital stays. Our objective was to synthesize the evidence on the effect of early in-hospital pharmacist-led medication review on patient-oriented outcomes based on observed data.

methodsWe systematically searched eight bibliographic reference databases, electronic grey literature, medical journals, conference proceedings, trial registries and bibliographies of relevant papers. We included studies that employed random or quasi-random methods to allocate subjects to pharmacist-led medication review or control. Medication review had to include, at a minimum, obtaining a best possible medication history and reviewing medications for appropriateness and adverse drug events. The intervention had to be initiated within 24 h of emergency department presentation or 72 h of admission. We extracted data in duplicate and pooled outcomes from clinically homogeneous studies of the same design using random effects meta-analysis.

resultsWe retrieved 4549 titles of which seven were included, reporting the outcomes of 3292 patients. We pooled data from studies of the same design, and found no significant differences in length of hospital admission (weighted mean difference [WMD] -0.04 days, 95% confidence interval [CI] -1.63, 1.55), mortality (odds ratio [OR] 1.09, 95% CI 0.69, 1.72), readmissions (OR 1.15, 95% CI 0.81, 1.63) or emergency department revisits at 3 months (OR 0.60, 95% CI 0.27, 1.32). Two large studies reporting reductions in readmissions could not be included in our pooled estimates due to differences in study design.

conclusionsWide confidence intervals suggest that additional research is likely to influence the effect size estimates and clarify the effect of medication review on patient-oriented outcomes. This systematic review failed to identify an effect of pharmacist-led medication review on health outcomes.

Indexed as

Medication Systems, HospitalDrug-Related Side Effects and Adverse ReactionsHospitalizationHumansadverse drug eventsclinical pharmacistclinical pharmacydrug related problemsmedication historymedication review

Identifiers

PMID25581134
PMCPMC4500324

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.