Evidence map›Paper›PMID 26861468›Full record

Trial reportDrugs & aging2016

Structured Pharmacist Review of Medication in Older Hospitalised Patients: A Cost-Effectiveness Analysis.

James Gallagher, David O'Sullivan, Suzanne McCarthy, Paddy Gillespie, Noel Woods, Denis O'Mahony, Stephen Byrne

Abstract 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. Cited by 27 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 8 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

27 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  5. Clinical and economic impact of medication reconciliation in cancer patients: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020
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  7. Hospital pharmacists working with geriatric patients in Europe: a systematic literature review.European journal of hospital pharmacy : science and practice · 2018
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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

7 authors.

James GallagherPharmaceutical Care Research Group, School of Pharmacy, University College Cork, College Road, Cork, Ireland.
David O'SullivanPharmaceutical Care Research Group, School of Pharmacy, University College Cork, College Road, Cork, Ireland.
Suzanne McCarthyPharmaceutical Care Research Group, School of Pharmacy, University College Cork, College Road, Cork, Ireland.
Paddy GillespieSchool of Business and Economics, National University of Ireland Galway, Galway, Ireland.
Noel WoodsCentre for Policy Studies, University College Cork, Cork, Ireland.
Denis O'MahonyDepartment of Geriatric Medicine, Cork University Hospital, Wilton, 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

backgroundA recent cluster randomised controlled trial (RCT) conducted in an Irish hospital evaluating a structured pharmacist review of medication (SPRM), supported by computerised clinical decision support software (CDSS), demonstrated positive outcomes in terms of reduction of adverse drug reactions (ADR).

objectiveThe aim of this study was to examine the cost effectiveness of pharmacists applying an SPRM in conjunction with CDSS to older hospitalised patients compared with usual pharmaceutical care.

methodCost-effectiveness analysis alongside a cluster RCT. The trial was conducted in a tertiary hospital in the south of Ireland. Patients in the intervention arm (n = 361) received a multifactorial intervention consisting of medicines reconciliation, deployment of CDSS and generation of a pharmaceutical care plan. Patients in the control arm (n = 376) received usual care from the hospital pharmacy team. Incremental cost effectiveness was examined in terms of costs to the healthcare system and an outcome measure of ADRs during an inpatient hospital stay. Uncertainty in the analysis was explored using a cost-effectiveness acceptability curve (CEAC).

resultsOn average, the intervention arm was the dominant strategy in terms of cost effectiveness. Compared with usual care (control), the intervention was associated with a decrease of €807 [95% confidence interval (CI) -3443 to 1829; p = 0.548) in mean healthcare cost, and a decrease in the mean number of ADR events per patient of -0.064 (95% CI -0.135 to 0.008; p = 0.081). The probability of the intervention being cost effective at respective threshold values of €0, €250, €500, €750, €1000 and €5000 was 0.707, 0.713, 0.716, 0.718, 0.722 and 0.784, respectively.

conclusionsBased on the evidence presented, SPRM/CDSS is likely to be determined to be cost effective compared with usual pharmaceutical care. However, neither incremental costs nor effects demonstrated a statistically significant difference, therefore the results of this single-site study should be interpreted with caution.

Indexed as

AgedAged, 80 and overCost-Benefit AnalysisDecision Support Systems, ClinicalDrug-Related Side Effects and Adverse ReactionsFemaleHealth ExpendituresHumansIrelandLength of StayMaleMedication ReconciliationOutcome Assessment, Health CarePharmacy Service, Hospital

Identifiers

PMID26861468

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.