Evidence map›Paper›PMID 37597081›Full record

Observational studyEuropean journal of clinical pharmacology2023

Implementation of clinical medication review in a geriatric ward to reduce potentially inappropriate prescriptions among older adults.

Alexandre Meurant, Pascale Lescure, Claire Lafont, Wilhelm Pommier, Claire Delmas, Pablo Descatoire, Marie Baudon, Alexandra Muzard, Cédric Villain, Jean-Pierre Jourdan

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in European journal of clinical pharmacology, 2023. 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
1.1field-weighted citation impact, top 24% 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, 6 citations in OpenAlex.

  1. Observational
  2. Observational
  3. Article
  4. Article
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 2 institutions in 1 country.

Alexandre MeurantDepartment of Geriatrics, University Hospital of Caen Normandie, Caen, France. meurant-a@chu-caen.fr.
Pascale LescureDepartment of Geriatrics, University Hospital of Caen Normandie, Caen, France.
Claire LafontDepartment of Geriatrics, University Hospital of Caen Normandie, Caen, France.
Wilhelm PommierDepartment of Geriatrics, University Hospital of Caen Normandie, Caen, France.
Claire DelmasDepartment of Geriatrics, University Hospital of Caen Normandie, Caen, France.
Pablo DescatoireDepartment of Geriatrics, University Hospital of Caen Normandie, Caen, France.
Marie BaudonDepartment of Pharmacy, University Hospital of Caen Normandie, Caen, France.
Alexandra MuzardDepartment of Pharmacy, University Hospital of Caen Normandie, Caen, France.
Cédric VillainDepartment of Geriatrics, University Hospital of Caen Normandie, Caen, France.
Jean-Pierre JourdanDepartment of Pharmacy, Vire Hospital, Vire, France.
Université de Caen Normandie · FRInserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe impact of several pharmaceutical interventions to reduce the use of potentially inappropriate medications (PIMs) and potentially omitted medications (POMs) has been recently studied. We aimed to determine whether clinical medication review (CMR) (i.e. a systematic and patient-centred clinical assessment of all medicines currently taken by a patient) performed by a geriatrician and a pharmacist added to standard pharmaceutical care (SPC) (i.e. medication reconciliation and regular prescription review by the pharmacist) resulted in more appropriate prescribing compared to SPC among older inpatients.

methodsA retrospective observational single-centre study was conducted in a French geriatric ward. Six criteria for appropriate prescribing were chosen: the number of PIMs and POMs as defined by the STOPP/STARTv2 list, the total number of drugs prescribed, the number of administrations per day and the number of psychotropic and anticholinergic drugs. These criteria were compared between CMR and SPC group using linear and logistic regression models weighted on propensity scores.

resultsThere were 137 patients included, 66 in the CMR group and 71 in the SPC group. The mean age was 87 years, the sex ratio was 0.65, the mean number of drugs prescribed was 9, the mean MMSE was 21 and at admission 242 POMs, and 363 PIMs were prescribed. Clinical medication review did not reduce the number of PIMs at discharge compared to SPC (beta = - 0.13 [- 0.84; 0.57], p = 0.71) nor did it reduce the number of drugs prescribed (p = 0.10), the number of psychotropic drugs (p = 0.17) or the anticholinergic load (p = 0.87). Clinical medication review resulted in more POMs being prescribed than in standard pharmaceutical care (beta = - 0.39 [- 0.72; - 0.06], p = 0.02). Cardiology POMs were more implemented in the medication review group (p = 0.03).

conclusionClinical medication review did not reduce the number of PIMs but helped clinicians introduce underused drugs, especially cardiovascular drugs, which are known to be associated with morbidity and mortality risk reduction.

Indexed as

Inappropriate PrescribingMedication ReviewAged, 80 and overCholinergic AntagonistsHumansPotentially Inappropriate Medication ListRetrospective StudiesCholinergic AntagonistsClinical pharmacyHospitalInappropriate prescribingMedication reconciliationPharmacy servicePrescriptions

Identifiers

PMID37597081
OpenAlexW4385999842

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.