TY - JOUR
T1 - The impact of pharmacists-led medicines reconciliation on healthcare outcomes in secondary care
T2 - A systematic review and meta-analysis of randomized controlled trials
AU - Cheema, Ejaz
AU - Alhomoud, Farah Kais
AU - Kinsara, Amnah Shams Al-Deen
AU - Alsiddik, Jomanah
AU - Barnawi, Marwah Hassan
AU - Al-Muwallad, Morooj Abdullah
AU - Abed, Shatha Abdulbaset
AU - Elrggal, Mahmoud E
AU - Mohamed, Mahmoud M A
PY - 2018/3/28
Y1 - 2018/3/28
N2 - BACKGROUND: Adverse 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.OBJECTIVE: To update the previous assessment of pharmacist-led medication reconciliation by restricting the review to randomized controlled trials (RCTs) only.METHODS: Six 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.RESULTS: From 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.CONCLUSION: Pharmacists-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.
AB - BACKGROUND: Adverse 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.OBJECTIVE: To update the previous assessment of pharmacist-led medication reconciliation by restricting the review to randomized controlled trials (RCTs) only.METHODS: Six 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.RESULTS: From 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.CONCLUSION: Pharmacists-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.
KW - Humans
KW - Medication Reconciliation/methods
KW - Outcome Assessment (Health Care)
KW - Pharmacists
KW - Randomized Controlled Trials as Topic
KW - Secondary Care
U2 - 10.1371/journal.pone.0193510
DO - 10.1371/journal.pone.0193510
M3 - Review article
C2 - 29590146
SN - 1932-6203
VL - 13
JO - PLoS ONE
JF - PLoS ONE
IS - 3
M1 - e0193510
ER -