The impact of pharmacists-led medicines reconciliation on healthcare outcomes in secondary care: A systematic review and meta-analysis of randomized controlled trials

Ejaz Cheema, Farah Kais Alhomoud, Amnah Shams Al-Deen Kinsara, Jomanah Alsiddik, Marwah Hassan Barnawi, Morooj Abdullah Al-Muwallad, Shatha Abdulbaset Abed, Mahmoud E Elrggal, Mahmoud M A Mohamed

Research output: Contribution to journalReview articlepeer-review

22 Citations (Scopus)
108 Downloads (Pure)

Abstract

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.

Original languageEnglish
Article numbere0193510
Number of pages14
JournalPLoS ONE
Volume13
Issue number3
DOIs
Publication statusPublished - 28 Mar 2018

Keywords

  • Humans
  • Medication Reconciliation/methods
  • Outcome Assessment (Health Care)
  • Pharmacists
  • Randomized Controlled Trials as Topic
  • Secondary Care

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