Evidence map›Paper›PMID 28391409›Full record

Trial reportEuropean journal of clinical pharmacology2017

Pharmacist participation in hospital ward teams and hospital readmission rates among people with dementia: a randomized controlled trial.

Maria Gustafsson, Maria Sjölander, Bettina Pfister, Jeanette Jonsson, Jörn Schneede, Hugo Lövheim

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of clinical pharmacology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01504672 (A Randomized Controlled Pharmacist Intervention Study to Reduce Drug-related Problems and Readmissions Among Old People With Dementia), which is not on this map. Cited by 42 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing 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.

NCT01504672 nacompletednot on this map

A Randomized Controlled Pharmacist Intervention Study to Reduce Drug-related Problems and Readmissions Among Old People With Dementia

TypeinterventionalSponsorUmeå UniversityRan2012 to 2015Enrolled460ConditionsCognitive ImpairmentArmsMedication review
3 · Its place in the literature

Who cites it

42 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

6 authors.

Maria GustafssonDepartment of Pharmacology and Clinical Neuroscience, Division of Clinical Pharmacology, Umeå University, SE-901 85, Umeå, Sweden. maria.gustafsson@umu.se.
Maria SjölanderDepartment of Pharmacology and Clinical Neuroscience, Division of Clinical Pharmacology, Umeå University, SE-901 85, Umeå, Sweden.
Bettina PfisterDepartment of Pharmacology and Clinical Neuroscience, Division of Clinical Pharmacology, Umeå University, SE-901 85, Umeå, Sweden.
Jeanette JonssonDepartment of Pharmacology and Clinical Neuroscience, Division of Clinical Pharmacology, Umeå University, SE-901 85, Umeå, Sweden.
Jörn SchneedeDepartment of Pharmacology and Clinical Neuroscience, Division of Clinical Pharmacology, Umeå University, SE-901 85, Umeå, Sweden.
Hugo LövheimDepartment of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess whether comprehensive medication reviews conducted by clinical pharmacists as part of a healthcare team reduce drug-related hospital readmission rates among people with dementia or cognitive impairment.

methodsThis randomized controlled trial was carried out between January 9, 2012, and December 2, 2014. Patients aged ≥65 years with dementia or cognitive impairment admitted to three wards at two hospitals located in Northern Sweden were included.

resultsOf the 473 deemed eligible for participation, 230 were randomized to intervention and 230 to control group by block randomization. The primary outcome, risk of drug-related hospital readmissions, was assessed at 180 days of follow-up by intention-to-treat analysis. During the 180 days of follow-up, 18.9% (40/212) of patients in the intervention group and 23.0% (50/217) of those in the control group were readmitted for drug-related reasons (HR = 0.80, 95% CI = 0.53-1.21, p = 0.28, univariable Cox regression). Heart failure was significantly more common in the intervention group. After adjustment for heart failure as a potential confounder and an interaction term, multiple Cox regression analysis indicated that pharmacist participation significantly reduced the risk of drug-related readmissions (HR = 0.49, 95% CI = 0.27-0.90, p = 0.02). A post-hoc analysis showed a significantly reduced risk of 30-day readmissions due to drug-related problems in the total sample (without adjustment for heart failure).

conclusionParticipation of clinical pharmacists in healthcare team conducting comprehensive medication reviews did not significantly reduce the risk of drug-related readmissions in patients with dementia or cognitive impairment; however, post-hoc and subgroup analyses indicated significant effects favoring the intervention. More research is needed.

trial registrationClinical trials NCT01504672.

Indexed as

Medication ReconciliationPharmacistsAgedAged, 80 and overCognitive DysfunctionDementiaFemaleHumansKaplan-Meier EstimateMalePatient Care TeamPatient ReadmissionPharmacy Service, HospitalClinical pharmacistsDementiaDrug-related readmissionsMedication reviewsOld people

Identifiers

PMID28391409
PMCPMC5486919

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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.