Evidence map›Paper›PMID 29957885›Full record

ArticleBritish journal of clinical pharmacology2018

Can doctors identify older patients at risk of medication harm following hospital discharge? A multicentre prospective study in the UK.

Nikesh Parekh, Jennifer M Stevenson, Rebekah Schiff, J Graham Davies, Stephen Bremner, Tischa Van der Cammen, Jatinder Harchowal, Chakravarthi Rajkumar, Khalid Ali, PRIME study group

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
0.8field-weighted citation impact, top 28% 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

9 citing papers in PubMed, 20 citations in OpenAlex.

  1. Trial
  2. Criteria pharmacists use to refer patients to a post discharge pharmacist review clinic.Exploratory research in clinical and social pharmacy · 2025
    Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Observational
  8. Article
  9. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 3 countries.

Nikesh ParekhAcademic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, East Sussex, UK.ORCID 0000-0002-9988-3717
Jennifer M StevensonInstitute of Pharmaceutical Science, Kings College London, London, UK.
Rebekah SchiffDepartment of Ageing and Health, Guy's and St Thomas' NHS Foundation Trust, London, UK.
J Graham DaviesInstitute of Pharmaceutical Science, Kings College London, London, UK.
Stephen BremnerDepartment of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, East Sussex, UK.
Tischa Van der CammenAcademic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, East Sussex, UK.
Jatinder HarchowalPharmacy Department, The Royal Marsden NHS Foundation Trust, London, UK.
Chakravarthi RajkumarAcademic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, East Sussex, UK.
Khalid AliAcademic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, East Sussex, UK.
PRIME study group
Brighton and Sussex Medical School · GBKing's College - North Carolina · USGuy's and St Thomas' NHS Foundation Trust · GBRoyal Marsden NHS Foundation Trust · GB

Funding

Department of Health PB-PG-0711-25094National Institute of Health Research (NIHR) PB-PG-0711-25094
6 · The paper itself

Abstract

aimsMedication-related harm (MRH) is common in older adults following hospital discharge. In resource-limited health systems, interventions to reduce this risk can be targeted at high-risk patients. This study aims to determine whether (1) doctors can predict which older patients will experience MRH requiring healthcare following hospital discharge, (2) clinical experience and confidence in prediction influence the accuracy of the prediction.

methodsThis was a multicentre observational prospective study involving five teaching hospitals in England between September 2013 and November 2015. Doctors discharging patients (aged ≥65 years) from medical wards predicted the likelihood of their patient experiencing MRH requiring healthcare (hospital readmission or community healthcare) in the initial 8-week period post-discharge. Patients were followed up by senior pharmacists to determine MRH occurrence.

resultsData of 1066 patients (83%) with completed predictions and follow-up, out of 1280 recruited patients, were analysed. Patients had a median age of 82 years (65-103 years), and 58% were female. Most predictions (85%) were made by junior doctors with less than 5 years' clinical experience. There was no relationship between doctors' predictions and patient MRH (OR 1.10, 95% CI 0.82-1.46, P = 0.53), irrespective of years of clinical experience. Doctors' predictions were more likely to be accurate when they reported higher confidence in their prediction, especially in predicting MRH-associated hospital readmissions (OR 1.58, 95% CI 1.42-1.76, P < 0.001).

conclusionsClinical judgement of doctors is not a reliable tool to predict MRH in older adults post-discharge.

Indexed as

Drug MonitoringPatient DischargeAgedAged, 80 and overAge FactorsClinical CompetenceDrug-Related Side Effects and Adverse ReactionsEnglandFemaleFollow-Up StudiesHospitals, TeachingHumansMaleMedication ErrorsPatient ReadmissionPharmacy Service, Hospitalgeriatric medicinemedical educationpatient safetypharmacovigilanceprescribing

Identifiers

PMID29957885
PMCPMC6138491
OpenAlexW2810020471

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.