Abstract
BackgroundAdverse drug events (ADEs) impose a major clinical and cost burden on acute hospital services. It has been reported that medicines reconciliation provided by pharmacists is effective in minimizing the chances of hospital admissions related to adverse drug events.ObjectiveTo update the previous assessment of pharmacist-led medication reconciliation by restricting the review to randomized controlled trials (RCTs) only.MethodsSix major online databases were sifted up to 30 December 2016, without inception date (Embase, Medline Ovid, PubMed, BioMed Central, Web of Science and Scopus) to assess the effect of pharmacist-led interventions on medication discrepancies, preventable adverse drug events, potential adverse drug events and healthcare utilization. The Cochrane tool was applied to evaluate the chances of bias. Meta-analysis was carried out using a random effects model.ResultsFrom 720 articles identified on initial searching, 18 RCTs (6,038 patients) were included. The quality of the included studies was variable. Pharmacists-led interventions led to an important decrease in favour of the intervention group, with a pooled risk ratio of 42% RR 0.58 (95% CI 0.49 to 0.67) P<0.00001 in medication discrepancy. Reductions in healthcare utilization by 22% RR 0.78 (95% CI 0.61 to 1.00) P = 0.05, potential ADEs by10% RR 0.90 (95% CI 0.78 to 1.03) P = 0.65 and preventable ADEs by 27% RR 0.73 (0.22 to 2.40) P = 0.60 were not considerable.ConclusionPharmacists-led interventions were effective in reducing medication discrepancies. However, these interventions did not lead to a significant reduction in potential and preventable ADEs and healthcare utilization.
Highlights
Adverse drug events (ADEs) impose a major clinical [1,2] and cost burden on acute hospital services [3]
Pharmacists-led interventions led to an important decrease in favour of the intervention group, with a pooled risk ratio of 42% RR 0.58 P
Pharmacists-led interventions were effective in reducing medication discrepancies
Summary
Adverse drug events (ADEs) impose a major clinical [1,2] and cost burden on acute hospital services [3]. Patients are at a greater risk of experiencing an ADE through medication discrepancies to some extent during their movement within or out of hospital [5,6,7,8]. Medication reconciliation has been considered as an effective strategy to minimise the risk of medication discrepancies [12] that may be potentially associated with ADEs. Medication reconciliation refers to the “process of identifying the most accurate list of all medications a patient is taking . Using this list to provide correct medications for patients anywhere within the health system” [13]. It has been reported that medicines reconciliation provided by pharmacists is effective in minimizing the chances of hospital admissions related to adverse drug events
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