Evidence map›Paper›PMID 28302636›Full record

Trial reportBMJ open2017

Pharmacist provided medicines reconciliation within 24 hours of admission and on discharge: a randomised controlled pilot study.

Brit Cadman, David Wright, Amanda Bale, Garry Barton, James Desborough, Eman A Hammad, Richard Holland, Helen Howe, Ian Nunney, Lisa Irvine

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 3 pooled it
2.8field-weighted citation impact, top 11% 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.

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

24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.

  1. Pooled it
  2. Reducing medication errors for adults in hospital settings.The Cochrane database of systematic reviews · 2021
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  3. Impact of medication reconciliation for improving transitions of care.The Cochrane database of systematic reviews · 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

10 authors at 3 institutions in 2 countries.

Brit CadmanPharmacy Department, Cambridge University Hospitals, Cambridge, UK.
David WrightSchool of Pharmacy, University of East Anglia, Norwich, UK.
Amanda BalePharmacy Department, Cambridge University Hospitals, Cambridge, UK.
Garry BartonNorwich Medical School, University of East Anglia, Norwich, UK.
James DesboroughSchool of Pharmacy, University of East Anglia, Norwich, UK.
Eman A HammadSchool of Pharmacy, University of Jordan, Jordan.
Richard HollandNorwich Medical School, University of East Anglia, Norwich, UK.
Helen HowePharmacy Department, Cambridge University Hospitals, Cambridge, UK.
Ian NunneyNorwich Medical School, University of East Anglia, Norwich, UK.
Lisa IrvineNorwich Medical School, University of East Anglia, Norwich, UK.
University of East Anglia · GBCambridge University Hospitals NHS Foundation Trust · GBUniversity of Jordan · JO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe UK government currently recommends that all patients receive medicines reconciliation (MR) from a member of the pharmacy team within 24 hours of admission and subsequent discharge. The cost-effectiveness of this intervention is unknown. A pilot study to inform the design of a future randomised controlled trial to determine effectiveness and cost-effectiveness of a pharmacist-delivered service was undertaken.

methodPatients were recruited 7 days a week from 5 adult medical wards in 1 hospital over a 9 month period and randomised using an automated system to intervention (MR within 24 hours of admission and at discharge) or usual care which may include MR (control). Recruitment and retention rates were determined. Length of stay (LOS), quality of life (EQ-5D-3L), unintentional discrepancies (UDs) and emergency readmission (ER) within 3 months were tested as outcome measures. The feasibility of identifying and measuring intervention-associated resources was determined.

result200 patients were randomised to either intervention or control. Groups were comparable at baseline. 95 (99%) patients in the intervention received MR within 24 hours, while 62 (60.8%) control patients received MR at some point during admission. The intervention resolved 250 of the 255 UDs identified at admission. Only 2 UDs were identified in the intervention group at discharge compared with 268 in the control. The median LOS was 94 hours in the intervention arm and 118 hours in the control, with ER rates of 17.9% and 26.7%, respectively. Assuming 5% loss to follow-up 1120 patients (560 in each arm) are required to detect a 6% reduction in 3-month ER rates.

conclusionsThe results suggest that changes in outcome measures resulting from MR within 24 hours were in the appropriate direction and readmission within 3 months is the most appropriate primary outcome measure. A future study to determine cost-effectiveness of the intervention is feasible and warranted. TRIAL REGISTRATION NUMBER: ISRCTN23949491.

Indexed as

HospitalizationPatient DischargeAgedCost-Benefit AnalysisFemaleHumansLength of StayMaleMedication ErrorsOutcome Assessment, Health CarePatient ReadmissionPatient SafetyPharmacistsPilot ProjectsUnited Kingdomcost-effectivenessmedicines reconciliationpharmacypilot studyrandomized controlled trial

Identifiers

PMID28302636
PMCPMC5372064
OpenAlexW2587176644

What OpenQuestion holds

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LicenceCC BY
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.