Evidence map›Paper›PMID 26597401›Full record

Trial reportDrugs & aging2016

Prevention of Adverse Drug Reactions in Hospitalised Older Patients Using a Software-Supported Structured Pharmacist Intervention: A Cluster Randomised Controlled Trial.

David O'Sullivan, Denis O'Mahony, Marie N O'Connor, Paul Gallagher, James Gallagher, Shane Cullinan, Richard O'Sullivan, Joseph Eustace, Stephen Byrne

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Drugs & aging, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05387096 (OPTImization of Medication by Transdisciplinary Assessment of Drug Treatment in Elderly Hospitalized Patients), which is not on this map. Cited by 47 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 10 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.

NCT05387096 naunknown statusnot on this mapstarted 2023, after this paper: background citation

OPTImization of Medication by Transdisciplinary Assessment of Drug Treatment in Elderly Hospitalized Patients: Application of a Definitive Intervention by Physicians or Clinical Pharmacists

TypeinterventionalSponsorUniversity College CorkRan2023 to 2024Enrolled642ConditionsMultimorbidity, PolypharmacyArmsDefinitive multi-faceted intervention consisting of several components, Sham Intervention
3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 10 syntheses or guidelines pooled it.

  1. Pooled it
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  5. Reducing medication errors for adults in hospital settings.The Cochrane database of systematic reviews · 2021
    Pooled it
  6. Pooled it
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  8. Hospital pharmacists working with geriatric patients in Europe: a systematic literature review.European journal of hospital pharmacy : science and practice · 2018
    Pooled it
  9. Pooled it
  10. Pooled it
  11. Health-related quality of life among older adults following acute hospitalization: longitudinal analysis of a randomized controlled trial.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024
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  17. Medication use quality and safety in older adults: 2022 update.Journal of the American Geriatrics Society · 2024
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  20. Article
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

9 authors.

David O'SullivanPharmaceutical Care Research Group, School of Pharmacy, University College Cork, College Road, Cork, Ireland.
Denis O'MahonyDepartment of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland.
Marie N O'ConnorDepartment of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland.
Paul GallagherDepartment of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland.
James GallagherPharmaceutical Care Research Group, School of Pharmacy, University College Cork, College Road, Cork, Ireland.
Shane CullinanPharmaceutical Care Research Group, School of Pharmacy, University College Cork, College Road, Cork, Ireland.
Richard O'SullivanPharmaceutical Care Research Group, School of Pharmacy, University College Cork, College Road, Cork, Ireland.
Joseph EustaceHealth Research Board of Ireland Clinical Research Facility, University College Cork, Cork, Ireland.
Stephen ByrnePharmaceutical Care Research Group, School of Pharmacy, University College Cork, College Road, Cork, Ireland. stephen.byrne@ucc.ie.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProven interventions to reduce adverse drug reactions (ADRs) in older hospitalised patients are lacking. Previous randomised controlled trial (RCT) data indicate that a structured pharmacist review of medication (SPRM) can reduce inappropriate prescribing in older hospitalised patients. However, no RCT data show that an SPRM reduces ADRs in this population.

methodsWe performed a cluster RCT comparing a clinical decision support software (CDSS)-supported SPRM intervention with standard pharmaceutical care in older patients hospitalised with an acute unselected illness. Over 13 months, we screened 1833 patients aged ≥65 years admitted to specialist services other than geriatric medicine for study inclusion. We randomised 361 patients to the trial intervention arm and 376 patients to the control arm, applying the intervention at a single timepoint within 48 h of admission. The primary endpoint (ADR incidence) was assessed at 7-10 days post-admission or at discharge (whichever came first). The secondary endpoints were the median hospital length of stay (LOS) and hospital mortality rate.

resultsAttending clinicians in the intervention group implemented 54.8% of SPRM/CDSS prescribing recommendations. Ninety-one ADRs occurred in 78 control patients (20.7%) compared with 61 ADRs in 50 intervention patients (13.9%), i.e., an absolute risk reduction of 6.8%. The number needed to treat (NNT) to prevent one patient having one ADR was 15; the total NNT to prevent one ADR was 14. The median LOS and hospital mortality were not significantly different.

conclusionAn SPRM delivered on a CDSS platform significantly reduces ADR incidence in acutely hospitalised older people.

Indexed as

HospitalizationAgedAged, 80 and overDrug-Related Side Effects and Adverse ReactionsFemaleHumansInappropriate PrescribingLength of StayMalePatient DischargePharmacistsSoftware

Identifiers

PMID26597401

What OpenQuestion holds

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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.