Evidence map›Paper›PMID 35715742›Full record

ArticleBMC geriatrics2022

The effect of structured medication review followed by face-to-face feedback to prescribers on adverse drug events recognition and prevention in older inpatients - a multicenter interrupted time series study.

Joanna E Klopotowska, Paul F M Kuks, Peter C Wierenga, Clementine C M Stuijt, Lambertus Arisz, Marcel G W Dijkgraaf, Nicolette de Keizer, Susanne M Smorenburg, Sophia E de Rooij, WINGS Study Group

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in BMC geriatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.5field-weighted citation impact, top 38% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

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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 5 institutions in 1 country.

Joanna E KlopotowskaAmsterdam University Medical Centers location University of Amsterdam, Medical Informatics, Amsterdam, The Netherlands. j.e.klopotowska@amsterdamumc.nl.ORCID 0000-0002-9707-5740
Paul F M KuksAmsterdam University Medical Centers location University of Amsterdam, Pharmacy and Clinical Pharmacology, Amsterdam, The Netherlands.
Peter C WierengaGelderse Vallei Hospital, Hospital Pharmacy, Ede, The Netherlands.
Clementine C M StuijtCenter of Excellence on Parkinson's disease (Punt voor Parkinson), Groningen, The Netherlands.
Lambertus AriszAmsterdam University Medical Centers location University of Amsterdam, Internal Medicine, Amsterdam, The Netherlands.
Marcel G W DijkgraafAmsterdam University Medical Centers location University of Amsterdam, Epidemiology and Data Science, Amsterdam, The Netherlands.
Nicolette de KeizerAmsterdam University Medical Centers location University of Amsterdam, Medical Informatics, Amsterdam, The Netherlands.
Susanne M SmorenburgAmsterdam University Medical Centers location University of Amsterdam, Internal Medicine, Amsterdam, The Netherlands.
Sophia E de RooijAmstelland Hospital, Board of Directors, Amstelveen, The Netherlands.
WINGS Study Group
Amsterdam University Medical Centers · NLGGD Amsterdam · NLPublic Health Service of Amsterdam · NLZiekenhuis Amstelland · NLZiekenhuis Gelderse Vallei · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effectiveness of interventions to improve medication safety in older inpatients is unclear, given a paucity of properly designed intervention studies applying clinically relevant endpoints such as hospital-acquired preventable Adverse Drug Events (pADEs) and unrecognized Adverse Drug Events (uADEs). Therefore, we conducted a quality improvement study and used hospital-acquired pADEs and uADEs as main outcomes to assess the effect of an intervention aimed to improve medication safety in older inpatients.

methodThe study followed an interrupted time series design and consisted of three equally spaced sampling points during baseline and during intervention measurements. Each sampling point included between 80 to 90 patients. A total of 500 inpatients ≥65 years and admitted to internal medicine wards of three Dutch hospitals were included. An expert team retrospectively identified and assessed ADEs via a structured patient chart review. The findings from baseline measurement and meetings with the internal medicine and hospital pharmacy staff were used to design the intervention. The intervention consisted of a structured medication review by hospital pharmacists, followed by face-to-face feedback to prescribers, on average 3 days per week.

resultsThe rate of hospital-acquired pADEs per 100 hospitalizations was reduced by 50.6% (difference 16.8, 95% confidence interval (CI): 9.0 to 24.6, P <  0.001), serious hospital-acquired pADEs by 62.7% (difference 12.8, 95% CI: 6.4 to 19.2, P <  0.001), and uADEs by 51.8% (difference 11.2, 95% CI: 4.4 to 18.0, P <  0.001). Additional analyses confirmed the robustness of the intervention effect, but residual bias cannot be excluded.

conclusionsThe intervention significantly decreased the overall and serious hospital-acquired pADE occurrence in older inpatients, and significantly improved overall ADE recognition by prescribers.

trial registrationInternational Standard Randomized Controlled Trial Number Register, trial registration number: ISRCTN64974377 , registration date (date assigned): 07/02/2011.

Indexed as

Drug-Related Side Effects and Adverse ReactionsInpatientsAgedFeedbackHumansInterrupted Time Series AnalysisMedication ErrorsMedication ReviewRetrospective StudiesAdverse drug eventsClinical pharmacistElderlyInpatientsInterrupted time seriesMedication review

Identifiers

PMID35715742
PMCPMC9206349
OpenAlexW4283020482

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.