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. 2023 Jan 23;1(1):CD008986.
doi: 10.1002/14651858.CD008986.pub4.

Medication review in hospitalised patients to reduce morbidity and mortality

Cille Bülow  1 , Stine Søndersted Clausen  2 , Andreas Lundh  3   4 , Mikkel Christensen  1   5   6
Affiliations

Medication review in hospitalised patients to reduce morbidity and mortality

Cille Bülow et al. Cochrane Database Syst Rev. .

Abstract

Background: A medication review can be defined as a structured evaluation of a patient's medication conducted by healthcare professionals with the aim of optimising medication use and improving health outcomes. Optimising medication therapy though medication reviews may benefit hospitalised patients.

Objectives: We examined the effects of medication review interventions in hospitalised adult patients compared to standard care or to other types of medication reviews on all-cause mortality, hospital readmissions, emergency department contacts and health-related quality of life.

Search methods: In this Cochrane Review update, we searched for new published and unpublished trials using the following electronic databases from 1 January 2014 to 17 January 2022 without language restrictions: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP). To identify additional trials, we searched the reference lists of included trials and other publications by lead trial authors, and contacted experts.

Selection criteria: We included randomised trials of medication reviews delivered by healthcare professionals for hospitalised adult patients. We excluded trials including outpatients and paediatric patients.

Data collection and analysis: Two review authors independently selected trials, extracted data and assessed risk of bias. We contacted trial authors for data clarification and relevant unpublished data. We calculated risk ratios (RRs) for dichotomous data and mean differences (MDs) or standardised mean differences (SMDs) for continuous data (with 95% confidence intervals (CIs)). We used the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach to assess the overall certainty of the evidence.

Main results: In this updated review, we included a total of 25 trials (15,076 participants), of which 15 were new trials (11,501 participants). Follow-up ranged from 1 to 20 months. We found that medication reviews in hospitalised adults may have little to no effect on mortality (RR 0.96, 95% CI 0.87 to 1.05; 18 trials, 10,108 participants; low-certainty evidence); likely reduce hospital readmissions (RR 0.93, 95% CI 0.89 to 0.98; 17 trials, 9561 participants; moderate-certainty evidence); may reduce emergency department contacts (RR 0.84, 95% CI 0.68 to 1.03; 8 trials, 3527 participants; low-certainty evidence) and have very uncertain effects on health-related quality of life (SMD 0.10, 95% CI -0.10 to 0.30; 4 trials, 392 participants; very low-certainty evidence).

Authors' conclusions: Medication reviews in hospitalised adult patients likely reduce hospital readmissions and may reduce emergency department contacts. The evidence suggests that mediation reviews may have little to no effect on mortality, while the effect on health-related quality of life is very uncertain. Almost all trials included elderly polypharmacy patients, which limits the generalisability of the results beyond this population.

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Conflict of interest statement

AL, CB, MC and SSC all declare no conflicts of interest relevant to this review.

Figures

1
1
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies. White spaces in this figure represent instances where it was not possible to make a judgement regarding objective or non‐objective outcomes.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included trial. White spaces in this figure represent instances where it was not possible to make a judgement regarding outcomes (e.g. outcome not included in relevant trial).
4
4
1.1
1.1. Analysis
Comparison 1: Primary outcome ‐ Trials comparing medication reviews with standard care, Outcome 1: Mortality (all‐cause)
2.1
2.1. Analysis
Comparison 2: Secondary outcomes ‐ Trials comparing medication reviews with standard care, Outcome 1: Hospital readmissions (all‐cause)
2.2
2.2. Analysis
Comparison 2: Secondary outcomes ‐ Trials comparing medication reviews with standard care, Outcome 2: Hospital readmissions (all‐cause) ‐ 3 months
2.3
2.3. Analysis
Comparison 2: Secondary outcomes ‐ Trials comparing medication reviews with standard care, Outcome 3: Hospital readmissions (all‐cause) ‐ 12 months
2.4
2.4. Analysis
Comparison 2: Secondary outcomes ‐ Trials comparing medication reviews with standard care, Outcome 4: Hospital readmissions (due to drug‐related adverse events)
2.5
2.5. Analysis
Comparison 2: Secondary outcomes ‐ Trials comparing medication reviews with standard care, Outcome 5: Hospital readmissions (due to drug‐related adverse events) ‐ 12 months
2.6
2.6. Analysis
Comparison 2: Secondary outcomes ‐ Trials comparing medication reviews with standard care, Outcome 6: Hospital emergency department contacts (all‐cause)
2.7
2.7. Analysis
Comparison 2: Secondary outcomes ‐ Trials comparing medication reviews with standard care, Outcome 7: Hospital emergency department contacts (all‐cause) ‐ 3 months
2.8
2.8. Analysis
Comparison 2: Secondary outcomes ‐ Trials comparing medication reviews with standard care, Outcome 8: Health‐related quality of life
3.1
3.1. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 1: Mortality (all‐cause): trials of participants taking a mean of ≥ 10 different medications versus trials of participants taking a mean of < 10 different medications
3.2
3.2. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 2: Hospital readmissions (all‐cause): trials of participants taking a mean of ≥ 10 different medications versus trials of participants taking a mean of < 10 different medications
3.3
3.3. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 3: Hospital emergency department contacts (all‐cause): trials of participants taking a mean of ≥ 10 different medications versus trials of participants taking a mean of < 10 different medications
3.4
3.4. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 4: Mortality (all‐cause): trials with criteria‐based medication review versus trials with non‐criteria‐based medication review
3.5
3.5. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 5: Hospital readmissions (all‐cause): trials with criteria‐based medication review versus trials with non‐criteria‐based medication review
3.6
3.6. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 6: Hospital emergency department contacts (all‐cause): trials with criteria‐based medication review versus trials with non‐criteria‐based medication review
3.7
3.7. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 7: Mortality (all‐cause): trials with low implementation rate versus trials with high implementation rate
3.8
3.8. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 8: Hospital readmissions (all‐cause): trials with low implementation rate versus trials with high implementation rate
3.9
3.9. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 9: Hospital emergency department contacts (all‐cause): trials with low implementation rate versus trials with high implementation rate
3.10
3.10. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 10: Mortality (all‐cause): trials with low risk of bias versus trials with high risk of bias
3.11
3.11. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 11: Hospital readmissions (all‐cause): trials with low risk of bias versus trials with high risk of bias
3.12
3.12. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 12: Hospital emergency department contacts (all‐cause): trials with low risk of bias versus trials with high risk of bias
3.13
3.13. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 13: Mortality (all‐cause): trials with extended medication reviews versus trials with basic medication reviews
3.14
3.14. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 14: Hospital readmissions (all‐cause): trials with extended medication reviews versus trials with basic medication reviews
3.15
3.15. Analysis
Comparison 3: Subgroup analysis ‐ Trials comparing medication reviews with standard care, Outcome 15: Hospital emergency department contacts (all‐cause): trials with extended medication reviews versus trials with basic medication reviews
4.1
4.1. Analysis
Comparison 4: Sensitivity analysis ‐ Trials comparing medication reviews with standard care, Outcome 1: Mortality (all‐cause) ‐ alternative ITT analysis
4.2
4.2. Analysis
Comparison 4: Sensitivity analysis ‐ Trials comparing medication reviews with standard care, Outcome 2: Hospital readmissions (all‐cause) ‐ alternative ITT analysis
4.3
4.3. Analysis
Comparison 4: Sensitivity analysis ‐ Trials comparing medication reviews with standard care, Outcome 3: Hospital emergency department contacts (all‐cause) ‐ alternative ITT analysis
4.4
4.4. Analysis
Comparison 4: Sensitivity analysis ‐ Trials comparing medication reviews with standard care, Outcome 4: Mortality (all‐cause) ‐ fixed‐effect
4.5
4.5. Analysis
Comparison 4: Sensitivity analysis ‐ Trials comparing medication reviews with standard care, Outcome 5: Hospital readmissions (all‐cause) ‐ fixed‐effect
4.6
4.6. Analysis
Comparison 4: Sensitivity analysis ‐ Trials comparing medication reviews with standard care, Outcome 6: Hospital emergency department contacts (all‐cause) ‐ fixed‐effect
4.7
4.7. Analysis
Comparison 4: Sensitivity analysis ‐ Trials comparing medication reviews with standard care, Outcome 7: Mortality (all‐cause) ‐ including adjusted data from cluster‐randomised cross‐over trials
4.8
4.8. Analysis
Comparison 4: Sensitivity analysis ‐ Trials comparing medication reviews with standard care, Outcome 8: Hospital readmissions (all‐cause) ‐ including adjusted data from cluster‐randomised cross‐over trials
4.9
4.9. Analysis
Comparison 4: Sensitivity analysis ‐ Trials comparing medication reviews with standard care, Outcome 9: Hospital emergency department contacts (all‐cause) ‐ including adjusted data from cluster‐randomised cross‐over trials
5.1
5.1. Analysis
Comparison 5: Trials comparing extended medication reviews with basic medication reviews, Outcome 1: Mortality (all‐cause)
5.2
5.2. Analysis
Comparison 5: Trials comparing extended medication reviews with basic medication reviews, Outcome 2: Hospital readmissions (all‐cause)
5.3
5.3. Analysis
Comparison 5: Trials comparing extended medication reviews with basic medication reviews, Outcome 3: Hospital emergency department contacts (all‐cause)
6.1
6.1. Analysis
Comparison 6: Sensitivity analysis ‐ Trials comparing extended medication reviews with basic medication reviews, Outcome 1: Mortality (all‐cause) ‐ alternative ITT analysis
6.2
6.2. Analysis
Comparison 6: Sensitivity analysis ‐ Trials comparing extended medication reviews with basic medication reviews, Outcome 2: Hospital readmissions (all‐cause) ‐ alternative ITT analysis
6.3
6.3. Analysis
Comparison 6: Sensitivity analysis ‐ Trials comparing extended medication reviews with basic medication reviews, Outcome 3: Hospital emergency department contacts (all‐cause) ‐ alternative ITT analysis
6.4
6.4. Analysis
Comparison 6: Sensitivity analysis ‐ Trials comparing extended medication reviews with basic medication reviews, Outcome 4: Mortality (all‐cause) ‐ fixed‐effect
6.5
6.5. Analysis
Comparison 6: Sensitivity analysis ‐ Trials comparing extended medication reviews with basic medication reviews, Outcome 5: Hospital readmissions (all‐cause) ‐ fixed‐effect
6.6
6.6. Analysis
Comparison 6: Sensitivity analysis ‐ Trials comparing extended medication reviews with basic medication reviews, Outcome 6: Hospital emergency department contacts (all‐cause) ‐ fixed‐effect
See this image and copyright information in PMC

Update of

References

References to studies included in this review

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Graabaek 2019 {published data only}
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Gustafsson 2017 {published and unpublished data}
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Lisby 2010 {published and unpublished data}
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Lisby 2015 {published data only}
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Ravn‐Nielsen 2018 {published and unpublished data}
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Scullin 2007 {published data only}
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Song 2021 {published data only}
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SUREPILL 2015 {published and unpublished data}
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References to studies excluded from this review

[no author] 2001 {published data only}
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AbuRuz 2021 {published data only}
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ACTRN12605000264684 2005 {unpublished data only}
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ACTRN12605000376640 2005 {unpublished data only}
    1. ACTRN12605000376640. Improving evidence based prescribing in older adults moving from hospital to long-term facilities with a pharmacist transition coordinator: a randomised controlled trial. http://www.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12605000376640 2005.
ACTRN12611000370909 2011 {unpublished data only}
    1. ACTRN12611000370909. Deprescribing in frail older people: a randomised controlled trial. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=336757 (first received 11 April 2011). - PMC - PubMed
ACTRN12611000995976 2011 {unpublished data only}
    1. ACTRN12611000995976. Application of a prescribing indicators tool to assist in identifying and resolving drug-related problems in older Australians - a randomized controlled trial. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347487 (first received 19 September 2011).
ACTRN12611001262998 2011 {unpublished data only}
    1. ACTRN12611001262998. A pilot study to assess the feasibility of a prospective randomised controlled trial of a patient-centred medicines management approach to reduce the burden of iatrogenic symptoms in palliative care. https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12611001262998 2011.
ACTRN12616001034426 2016 {unpublished data only}
    1. ACTRN12616001034426. Evaluation of partnered pharmacist charting at admission and discharge. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371206 (first received 4 August 2016).
ACTRN12616001474448 2016 {unpublished data only}
    1. ACTRN12616001474448. Pharmacist involvement in helping patients at discharge from hospital and the effect on their wellbeing and readmission to hospital. http://www.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12616001474448 2016.
ACTRN12617001293358 2017 {unpublished data only}
    1. ACTRN12617001293358. Impact of a chronic disease management model in patients with decompensated liver disease: The Australian Liver Failure Trial (ALFIE). https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372421 (first received 7 September 2017).
ACTRN12618000250235 2018 {unpublished data only}
    1. ACTRN12618000250235. (M)ultifactorial (I)ntervention in Patients with (P)eripheral (A)rterial (D)isease - a randomised controlled trial. http://www.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12618000250235 2018.
ACTRN12618000794202 2018 {unpublished data only}
    1. ACTRN12618000794202. Comprehensive geriatric assessment and interventions in older lung cancer patients. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372397 (first received 10 May 2018).
ACTRN12619000729123 2019 {unpublished data only}
    1. ACTRN12619000729123. Preventing adverse drug reactions in older Australians. http://www.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12619000729123 2019.
Ahmad 2012 {published data only}
    1. Ahmad A, Nijpels G, Dekker JM, Kostense PJ, Hugtenburg JG. Effect of a pharmacist medication review in elderly patients discharged from the hospital. Archives of Internal Medicine 2012;172(17):1346-7. [PMID: ] - PubMed
Al‐Hashar 2018 {published data only}
    1. Al-Hashar A, Al-Zakwani I, Eriksson T, Sarakbi A, Al-Zadjali B, Al Mubaihsi S, et al. Impact of medication reconciliation and review and counselling, on adverse drug events and healthcare resource use. International Journal of Clinical Pharmacy 2018;40(5):1154-64. - PubMed
Alicic 2016 {published data only}
    1. Alicic RZ, Short RA, Corbett CL, Neumiller JJ, Gates BJ, Daratha KB, et al. Medication intervention for chronic kidney disease patients transitioning from hospital to home: study design and baseline characteristics. American Journal of Nephrology 2016;44(2):122-9. - PMC - PubMed
Allen 1986 {published data only}
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Al Mazroui 2009 {published data only}
    1. Al Mazroui NR, Kamal MM, Ghabash NM, Yacout TA, Kole PL, McElnay JC. Influence of pharmaceutical care on health outcomes in patients with Type 2 diabetes mellitus. British Journal of Clinical Pharmacology 2009;67(5):547-57. [PMID: ] - PMC - PubMed
Al‐Rashed 2002 {published data only}
    1. Al-Rashed SA, Wright DJ, Roebuck N, Sunter W, Chrystyn H. The value of inpatient pharmaceutical counselling to elderly patients prior to discharge. British Journal of Clinical Pharmacology 2002;54(6):657-64. [PMID: ] - PMC - PubMed
Awdishu 2016 {published data only}
    1. Awdishu L, Coates CR, Lyddane A, Tran K, Daniels CE, Lee J, et al. The impact of real-time alerting on appropriate prescribing in kidney disease: a cluster randomized controlled trial. Journal of the American Medical Informatics Association: JAMIA 2016;23(3):609-16. - PMC - PubMed
Balaban 2015 {published data only}
    1. Balaban RB, Galbraith AA, Burns ME, Vialle-Valentin CE, Larochelle MR, Ross-Degnan D. A patient navigator intervention to reduce hospital readmissions among high-risk safety-net patients: a randomized controlled trial. Journal of General Internal Medicine 2015;30(7):907-15. - PMC - PubMed
Basoor 2011 {published data only}
    1. Basoor A, Doshi N, Cotant J, Todorov M, Saleh T, Patel K, et al. Result of quality improvement discharge tool in congestive heart failure-randomized controlled trial. Chest 2011;140(4). [DOI: 10.1378/chest.1113754] - DOI
Bell 2016 {published data only}
    1. Bell SP, Schnipper JL, Goggins K, Bian A, Shintani A, Roumie CL, et al. Effect of pharmacist counseling intervention on health care utilization following hospital discharge: a randomized control trial. Journal of General Internal Medicine 2016;31(5):470-7. - PMC - PubMed
Bhagwan 2018 {published data only}
    1. Bhagwan V, Kirke C, Meehan F, Hickey M, Kinlan E, Grimes T. A quality improvement project addressing peri-operative medication reconciliation and administration in elective surgical patients using five or more medications pre-admission. International Journal of Pharmacy Practice 2018;26:35-6.
Boland 2016 {published data only}
    1. Boland B, Guignard B, Dalleur O, Lang PO. Application of STOPP/START and Beers criteria: compared analysis on identification and relevance of potentially inappropriate prescriptions. European Geriatric Medicine 2016;7(5):416-23.
Bolas 2004 {published data only}
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Bondesson 2013 {published data only}
    1. Bondesson A, Eriksson T, Kragh A, Holmdahl L, Midlov P, Hoglund P. In-hospital medication reviews reduce unidentified drug-related problems. European Journal of Clinical Pharmacology 2013;69(3):647-55. [PMID: ] - PubMed
Bonnet‐Zamponi 2010 {published data only}
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Bonnet‐Zamponi 2013 {published data only}
    1. Bonnet-Zamponi D, d'Arailh L, Konrat C, Delpierre S, Lieberherr D, Lemaire A, et al. Drug-related readmissions to medical units of older adults discharged from acute geriatric units: results of the Optimization of Medication in AGEd multicenter randomized controlled trial. Journal of the American Geriatrics Society 2013;61(1):113-21. [PMID: ] - PubMed
Brecher 2015 {published data only}
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Briggs 2015 {published data only}
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Bruhwiler 2018 {published data only}
    1. Bruhwiler LD, Beeler PE, Boni F, Wiedemeier PG, Hersberger KE, Lutters M. A pragmatic in-hospital service to reduce workload of community pharmacists after discharge: a randomised controlled trial. International Journal of Clinical Pharmacy 2018;40(1):207.
Bruhwiler 2019 {published data only}
    1. Bruhwiler LD, Beeler PE, Boni F, Giger R, Wiedemeier PG, Hersberger KE, et al. A RCT evaluating a pragmatic in-hospital service to increase the quality of discharge prescriptions. International Journal for Quality in Health Care 2019;31(8):G74-80. [DOI: 10.1093/intqhc/mzz043] - DOI - PubMed
Bulow 2018 {published data only}
    1. Bulow C, Faerch KU, Armandi H, Jensen BN, Sonne J, Christensen HR, et al. Important aspects of pharmacist-led medication reviews in an acute medical ward. Basic & Clinical Pharmacology & Toxicology 2018;122(2):253-61. - PubMed
Burleson 2003 {published data only}
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Burnett 2009 {published data only}
    1. Burnett KM, Scott MG, Fleming GF, Clark CM, McElnay JC. Effects of an integrated medicines management program on medication appropriateness in hospitalized patients. American Journal of Health-System Pharmacy 2009;66(9):854-9. - PubMed
Capobussi 2016 {published data only}
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Chen 2014 {published data only}
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Chiu 2018 {published data only}
    1. Chiu KC, Lee WK, See YW, Chan HW. Outcomes of a pharmacist-led medication review programme for hospitalised elderly patients. Hong Kong Medical Journal 2018;24(2):98-106. [DOI: 10.12809/hkmj176871] - DOI - PubMed
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Connor 2012 {unpublished data only}
    1. Connor MO, O'Sullivan D, Gallagher P, Byrne S, Eustace J, O'Mahony D. Prevention of adverse drug events in hospitalised older patients: a randomised controlled trial. Irish Journal of Medical Science 2012;181:S181-223.
Crotty 2004 {published data only}
    1. Crotty M, Rowett D, Spurling L, Giles LC, Phillips PA. Does the addition of a pharmacist transition coordinator improve evidence-based medication management and health outcomes in older adults moving from the hospital to a long-term care facility? Results of a randomized, controlled trial. American Journal of Geriatric Pharmacotherapy 2004;2(4):257-64. [PMID: ] - PubMed
CTRI/2014/08/004900 2014 {unpublished data only}
    1. CTRI/2014/08/004900. Impact of pharmaceutical care on quality of life among chronic kidney disease patients on hemodialysis. http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=8802&EncH... 2014.
Dalton 2018 {published data only}
    1. Dalton K, O'Mahony D, O'Sullivan D, O'Connor NM, Byrne S. Prescriber acceptance of STOPP/START recommendations for hospitalised older adults: pharmacist versus physician-secondary analysis of data from two randomised controlled trials. In: International Journal of Pharmacy Practice. Vol. 26. 2018:21-2.
Dalton 2019 {published data only}
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Dalton 2019a {published data only}
    1. Dalton K, O'Mahony D, O'Sullivan D, O'Connor MN, Byrne S. Prescriber implementation of STOPP/START recommendations for hospitalised older adults: a comparison of a pharmacist approach and a physician approach. Drugs & Aging 2019;36(3):279-88. - PubMed
Dauphinot 2017 {published data only}
    1. Dauphinot V, Jean-Bart E, Krolak-Salmon P, Mouchoux C. A multi-center, randomized, controlled trial to assess the efficacy of optimization of drug prescribing in an elderly population, at 18 months of follow-up, in the evolution of functional autonomy: the OPTIM study protocol. BMC Geriatrics 2017;17(1):195. - PMC - PubMed
DRKS00007696 2015 {unpublished data only}
    1. DRKS00007696. Impact of a a pharmaceutical consultation service on palliative care pharmacotherapy. http://www.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00007696 2015.
DRKS00013321 2017 {unpublished data only}
    1. DRKS00013321. GLICEMIA 2.0 – a randomized, controlled trial of secondary and tertiary prevention in a type 2 diabetic population. GLICEMIA 2.0 – a randomized, controlled trial of secondary and tertiary prevention in a type 2 diabetic population - GLICEMIA 2.0 2017.
DRKS00013538 2017 {unpublished data only}
    1. DRKS00013538. Perioperative drug therapy management in very old patients by a geriatric-pharmaceutical team. http://www.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00013538 2017.
Dudley‐Brown 2016 {published data only}
    1. Dudley-Brown S, Andros V, Hinkle J, Caines J. Adherence and long-term IBD value-added effectiveness (alive): effectiveness of a patient fulfillment model in a large academic center IBD clinic. Inflammatory Bowel Diseases 2016;22:S30.
Ee 2019 {published data only}
    1. Ee CAJM, Lee KH, Tan HL, Low LL. Effectiveness and feasibility of deprescribing of symptomatic medications in a Singapore rehabilitation hospital. Proceedings of Singapore Healthcare 2019;28(1):31-8.
Erku 2017 {published data only}
    1. Erku DA, Belachew SA, Tegegn HG, Ayele AA. The impact of pharmacist-led medication therapy management on medication adherence in patients with type 2 diabetes mellitus: a randomized controlled study. Value in Health 2017;20(9):A402. - PMC - PubMed
EUCTR‐004236‐38‐GB 2016 {unpublished data only}
    1. EUCTR-004236-38-GB. Optimising treatment for mild systolic hypertension in the elderly. http://www.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2016-004236-38-GB 2016.
Franchi 2016 {published data only}
    1. Franchi C, Tettamanti M, Djade CD, Pasina L, Mannucci PM, Onder G, et al. E-learning in order to improve drug prescription for hospitalized older patients: a cluster-randomized controlled study. British Journal of Clinical Pharmacology 2016;82(1):53-63. - PMC - PubMed
Frankenthal 2014 {published data only}
    1. Frankenthal D, Lerman Y, Kalendaryev E, Lerman Y. Intervention with the screening tool of older persons potentially inappropriate prescriptions/screening tool to alert doctors to right treatment criteria in elderly residents of a chronic geriatric facility: a randomized clinical trial. Journal of the American Geriatrics Society 2014;62(9):1658-65. [PMID: ] - PubMed
Frankenthal 2017 {published data only}
    1. Frankenthal D, Israeli A, Caraco Y, Lerman Y, Kalendaryev E, Zandman-Goddard G. Long-term outcomes of medication intervention using the screening tool of older persons potentially inappropriate prescriptions screening tool to alert doctors to right treatment criteria. Journal of the American Geriatrics Society 2017;65(2):e33-8. - PubMed
Gallagher 2015 {published data only}
    1. Gallagher J, O'Sullivan D, McCarthy S, Gillespie P, Woods N, O'Mahony D, et al. A cost-effectiveness analysis of hospital pharmacist review in older patients. Value in health 2015;18(7):A732-3.
Gallagher 2015a {published data only}
    1. Gallagher J, McCarthy S, O'Sullivan D, O'Mahony D, Gillespie P, Woods N, et al. Economic evaluation of a software-supported structured pharmacist medication review in hospitalised older patients. International Journal of Pharmacy Practice 2015;23:13-4.
Gallagher 2016 {published data only}
    1. Gallagher J, O'Sullivan D, McCarthy S, Gillespie P, Woods N, O'Mahony D, et al. Structured pharmacist review of medication in older hospitalised patients: a cost-effectiveness analysis. Drugs & Aging 2016;33(4):285-94. - PubMed
Gallagher 2017 {published data only}
    1. Gallagher J, O'Sullivan D, McCarthy S, Gillespie P, Woods N, O'Mahony D, et al. Structured pharmacist review of medication in older hospitalised patients: a cost effectiveness analysis. European Journal of Hospital Pharmacy 2017;24:A6. - PubMed
Garcia 2015 {published data only}
    1. Garcia BH, Giverhaug T, Hogli JU, Skjold F, Smabrekke L. A pharmacist-led follow-up program for patients with established coronary heart disease in North Norway - a randomized controlled trial. Pharmacy Practice 2015;13(2):575. - PMC - PubMed
Gattis 1999 {published data only}
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Geneletti 2019 {published data only}
    1. Geneletti L, Chanoine S, Lugosi M, Allenet B, Bouilet L, Bedouch P, et al. Impact of hospital-city communication based on the multiprofessional and collaborative development of the discharge letter on the continuity of patients' medication management-city study. European Journal of Hospital Pharmacy 2019;26:A172.
George 2011 {published data only}
    1. George LJW, Senturk-Raif R, Hodgkinson MR, Emmerton M, Larmour I. Impact of a surgical preadmission clinic pharmacist on the quality of medication management from preadmission to discharge: a randomised controlled study. Journal of Pharmacy Practice and Research 2011;41(3):212-6.
Gines 2016 {published data only}
    1. Gines A, Sanchez Navarro I, Santolaya Perrin R, Galan N, Sierra J, Moreno MT, et al. Inappropriate prescribing in elderly patients attending the emergency room. European Journal of Hospital Pharmacy 2016;23:A56.
Goldberg 2019 {published data only}
    1. Goldberg EM, Resnik L, Mor V, Marks SJ, Merchant RC, Kennedy M. Feasibility and initial efficacy of gapcare: the geriatric acute and post-acute care coordination fall prevention program. Academic Emergency Medicine 2019;26:S125.
Granados 2020 {published data only}
    1. Granados J, Salazar-Ospina A, Botero-Aguirre JP, Valencia-Quintero AF, Ortiz N, Amariles P. Effect and associated factors of a clinical pharmacy model in the incidence of medication errors (EACPharModel) in the Hospital Pablo Tobon Uribe: study protocol for a stepped wedge randomized controlled trial (NCT03338725). Trials 2020;21(1):26. - PMC - PubMed
Hedegaard 2014 {published data only}
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Hedegaard 2015 {published data only}
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Hellstrom 2011 {published data only}
    1. Hellstrom LM, Bondesson A, Hoglund P, Midlov P, Holmdahl L, Rickhag E, et al. Impact of the Lund Integrated Medicines Management (LIMM) model on medication appropriateness and drug-related hospital revisits. European Journal of Clinical Pharmacology 2011;67(7):741-52. [PMID: ] - PubMed
Heselmans 2015 {published data only}
    1. Heselmans A, Krieken J, Cootjans S, Nagels K, Filliers D, Dillen K, et al. Medication review by a clinical pharmacist at the transfer point from ICU to ward: a randomized controlled trial. Journal of Clinical Pharmacy and Therapeutics 2015;40(5):578-83. - PubMed
Ho 2013 {published data only}
    1. Ho M, Lambert-Kerzner A, Carey E, Fahdi I, Bryson C, Melnyk DS, et al. Multifaceted intervention to improve medication adherence and secondary prevention measures (Medication study) after acute coronary syndrome hospital discharge. Circulation 2013;128(24):2706-7. - PubMed
Hohl 2017 {published data only}
    1. Hohl CM, Partovi N, Ghement I, Wickham ME, McGrail K, Reddekopp LN, et al. Impact of early in-hospital medication review by clinical pharmacists on health services utilization. PLOS One 2017;12(2):e0170495. - PMC - PubMed
Ilting‐Reuke 2018 {published data only}
    1. Ilting-Reuke K, Duning T, Roos A, Ohrmann P, Hempel G. Management of delirium in an acute care hospital. European Journal of Hospital Pharmacy 2018;25:A124-5.
Iltingreuke 2019 {published data only}
    1. Iltingreuke K, Roos A, Ohrmann P, Duning T, Hempel G. Management of delirium in elderly people: a randomized controlled trial. International Journal of Clinical Pharmacy 2019;41(1):295.
ISRCTN01624723 2007 {unpublished data only}
    1. ISRCTN01624723. Medication error and adverse event detection and resolution by a pharmacist in the Emergency Department at Southampton General Hospital. Sub-study on patient views about medication. http://www.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN01624723 2007.
ISRCTN11674947 2012 {published data only}
    1. ISRCTN11674947. The Malaysian Falls Assessment and Intervention Trial. lhttps://www.isrctn.com/ISRCTN11674947 (first received 27 November 2012).
ISRCTN11751440 2017 {published data only}
    1. ISRCTN11751440. Hospital pharmacists successfully work with the acute care team to stop home medications deemed no longer necessary. Impact of Deprescribing Rounds on Outpatient Prescriptions: An Interventional Trial 2017.
ISRCTN17219647 2017 {unpublished data only}
    1. ISRCTN17219647. GeriMedRisk®, a telemedicine geriatric pharmacology consultation service to address adverse drug events in long-term care. http://www.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN17219647 2017. - PMC - PubMed
ISRCTN32281812 2017 {unpublished data only}
    1. ISRCTN32281812. Effectiveness of a pharmacist intervention in patients with lung disease. http://www.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN32281812 2017.
ISRCTN38449870 2013 {unpublished data only}
    1. ISRCTN38449870. Reduction of inappropriate medication and adverse drug events in older patients. http://www.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN38449870 2013.
JPRN‐UMIN000024250 2016 {unpublished data only}
    1. JPRN-UMIN000024250. SADA-5 (Strategy of Assessment for Drug Appropriateness) criteria as a powerful tool for detecting potentially inappropriate medications with using another explicit criteria; a randomized control trial. http://www.who.int/trialsearch/Trial2.aspx?TrialID=JPRN-UMIN000024250 2016.
JPRN‐UMIN000033814 2018 {unpublished data only}
    1. JPRN-UMIN000033814. The Intervention study for Medication assist provided by pharmacist for the elderly with polypharmacy. https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000038567 (first received 20 August 2018).
Kang 2018 {published data only}
    1. Kang JE, Yu JM, Choi JH, Chung IM, Pyun WB, Kim SA, et al. Development and clinical application of an evidence-based pharmaceutical care service algorithm in acute coronary syndrome. Journal of Clinical Pharmacy and Therapeutics 2018;43(3):366-76. - PubMed
Karapinar‐Çarkıt 2017 {published data only}
    1. Karapinar-Çarkıt F, Knaap R, Bouhannouch F, Borgsteede SD, Janssen MJA, Siegert CEH, et al. Cost-effectiveness of a transitional pharmaceutical care program for patients discharged from the hospital. PLOS One 2017;12(4):e0174513. - PMC - PubMed
KCT0005994 {published and unpublished data}
    1. Lee S, Yu YM, Han E, Park MS, Lee J-H, Chang MJ. Effect of pharmacist intervention on 30-adverse drug event after discharge in elderly patients through a comprehensive medication reconciliation: a randomized clinical trial. https://assets.researchsquare.com/files/rs-1092054/v1/41fe85c2-dbf0-4942... 9 December 2021:(preprint). [DOI: 10.21203/rs.3.rs-1092054/v1] - DOI - PMC - PubMed
Kelly 2011 {published data only}
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    1. Kindstedt J, Svahn S, Sjölander M, Glader EL, Lövheim H, Gustafsson M. Investigating the effect of clinical pharmacist intervention in transitions of care on drug-related hospital readmissions among the elderly: study protocol for a randomised controlled trial. BMJ Open 2020;10(4):e036650. - PMC - PubMed
Koehler 2009 {published data only}
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Lea 2018 {published data only}
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Leguelinel‐Blache 2018 {published data only}
    1. Leguelinel-Blache G, Castelli C, Roux-Marson C, Bouvet S, Andrieu S, Cestac P, et al. Impact of collaborative pharmaceutical care on in-patients' medication safety: study protocol for a stepped wedge cluster randomized trial (MEDREV study). Trials 2018;19(1):19. - PMC - PubMed
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Lind 2017 {published data only}
    1. Lind KB, Soerensen CA, Salamon SA, Kirkegaard H, Lisby M. Consequence of delegating medication-related tasks from physician to clinical pharmacist in an acute admission unit: an analytical study. European Journal of Hospital Pharmacy: Science and Practice 2017;24(5):272-7. - PMC - PubMed
Lipton 1992 {published data only}
    1. Lipton HL, Bero LA, Bird JA, McPhee SJ. The impact of clinical pharmacists' consultations on physicians' geriatric drug prescribing. A randomized controlled trial. Medical Care 1992;30(7):646-58. [PMID: ] - PubMed
Lonnbro 2017 {published data only}
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Mao 2015 {published data only}
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Marinovic 2021 {published data only}
    1. Marinović I, Bačić Vrca V, Samardžić I, Marušić S, Grgurević I, Papić I, et al. Impact of an integrated medication reconciliation model led by a hospital clinical pharmacist on the reduction of post-discharge unintentional discrepancies. Journal of Clinical Pharmacy and Therapeutics 2021;46(5):1326-33. - PubMed
Martinez 2019 {published data only}
    1. Martinez MF, Herrada L, Munoz A, Chavez C, Sandoval T, Jiron M. Effect of a clinical pharmacist intervention on the emergency department revisits: a randomized controlled trial. In: Pharmacoepidemiology and Drug Safety. Vol. 28. 2019:199‐200.
Marusic 2013 {published data only}
    1. Marusic S, Gojo-Tomic N, Erdeljic V, Bacic-Vrca V, Franic M, Kirin M, et al. The effect of pharmacotherapeutic counselling on readmissions and emergency department visits. International Journal of Clinical Pharmacy 2013;35(1):37-44. [PMID: ] - PubMed
Mateti 2018 {published data only}
    1. Mateti UV, Nagappa AN, Attur RP, Nagaraju SP, Rangaswamy D. Impact of pharmaceutical care on clinical outcomes among hemodialysis patients: a multicenter randomized controlled study. Saudi Journal of Kidney Diseases and Transplantation 2018;29(4):801-8. - PubMed
McCoy 2012 {published data only}
    1. McCoy AB, Cox ZL, Neal EB, Waitman LR, Peterson NB, Bhave G, et al. Real-time pharmacy surveillance and clinical decision support to reduce adverse drug events in acute kidney injury: a randomized, controlled trial. Applied clinical informatics 2012;3(2):221-38. - PMC - PubMed
McDonald 2018 {published data only}
    1. McDonald E, Lee T, Wu P, Downar J, Goodine C. The medsafer pilot results: electronic deprescribing for hospitalized older adults with polypharmacy. BMJ Evidence-based Medicine 2018;23:A25-6.
McMullin 1999 {published data only}
    1. McMullin ST, Hennenfent JA, Ritchie DJ, Huey WY, Lonergan TP, Schaiff RA, et al. A prospective, randomized trial to assess the cost impact of pharmacist-initiated interventions. Archives of Internal Medicine 1999;159(19):2306-9. [PMID: ] - PubMed
Mendes 2021 {published data only}
    1. Mendes A. Multimorbidity, optimising treatment and preventing hospital admissions in older people. Journal of Prescribing Practice 2021;3(9).
Michalek 2014 {published data only}
    1. Michalek C, Wehling M, Schlitzer J, Frohnhofen H. Effects of "Fit fOR The Aged" (FORTA) on pharmacotherapy and clinical endpoints--a pilot randomized controlled study. European Journal of Clinical Pharmacology 2014;70(10):1261-7. - PubMed
Mishra 2017 {published data only}
    1. Mishra A, Sai Krishna G, Sravani A, Kurian TD, Kurian J, Ramesh M, et al. Impact of pharmacist-led collaborative patient education on medication adherence and quality of life of schizophrenia patients in a tertiary care setting. Bulletin of Faculty of Pharmacy, Cairo University 2017;55(2):345-9.
Nachtigall 2019 {published data only}
    1. Nachtigall A, Heppner HJ, Thurmann PA. Influence of pharmacist intervention on drug safety of geriatric inpatients: a prospective, controlled trial. Therapeutic Advances in Drug Safety 2019;10:2042098619843365. - PMC - PubMed
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    1. Naughton BJ, Moran MB, Feinglass J, Falconer J, Williams ME. Reducing hospital costs for the geriatric patient admitted from the emergency department: a randomized trial. Journal of the American Geriatrics Society 1994;42(10):1045-9. [PMID: ] - PubMed
NCT00205140 2005 {unpublished data only}
    1. NCT00205140. Effect of pharmacist initiated recommendations on prescribing for participants in the senior meds personalized medication review. https://clinicaltrials.gov/ct2/show/NCT00205140 (first received 20 September 2005).
NCT00279656 2006 {unpublished data only}
    1. NCT00279656. Benefit of a collaborative approach to improve the quality of medicines use in elderly inpatients. https://clinicaltrials.gov/show/NCT00279656 (first received 19 January 2006).
NCT00351676 2006 {unpublished data only}
    1. NCT00351676. Capturing outcomes of clinical activities performed by a rounding pharmacist practising in a team environment (COLLABORATE). https://www.clinicaltrials.gov/ct2/show/NCT00351676 (first received 13 July 2006). - PubMed
NCT00416026 2006 {unpublished data only}
    1. NCT00416026. Translating research: patient decision support/coaching. https://clinicaltrials.gov/show/NCT00416026 (first received 27 December 2006).
NCT00541606 {unpublished data only}
    1. NCT00541606. Pharmacist assisted medication program enhancing the regulation of diabetes. https://clinicaltrials.gov/ct2/show/NCT00541606 (first received 10 October 2007).
NCT00773942 2010 {unpublished data only}
    1. NCT00773942. Design & evaluation of a medication therapy management program to improve patient safety in medicare beneficiaries. https://clinicaltrials.gov/ct2/show/NCT00773942 (first received 16 October 2008).
NCT00844025 2010 {unpublished data only}
    1. NCT00844025. Pharmaceutical care and clinical outcomes for the elderly taking potentially inappropriate medication. https://clinicaltrials.gov/ct2/show/NCT00844025 (first received 13 February 2009).
NCT01034761 2009 {unpublished data only}
    1. NCT01034761. Using clinical alerts to decrease inappropriate medication prescribing. https://clinicaltrials.gov/show/NCT01034761 (first received 17 December 2009).
NCT01134900 2010 {unpublished data only}
    1. NCT01134900. Achieving medication safety during acute kidney injury. https://clinicaltrials.gov/ct2/show/NCT01134900 (first received 2 June 2010).
NCT01164137 2013 {unpublished data only}
    1. NCT01164137. Eliminating risk of preventable adverse drug events at the hospital-community interface of care. https://clinicaltrials.gov/ct2/show/NCT01164137 (first received 16 July 2010).
NCT01212211 2011 {unpublished data only}
    1. NCT01212211. Hyponatremia in the elderly: benefit from a change in drug therapy? https://clinicaltrials.gov/ct2/show/NCT01212211 (first received 30 September 2010).
NCT01356563 2011 {unpublished data only}
    1. NCT01356563. Efficacy study of pharmacist intervention on medication-related problems in hemodialysis patients. https://clinicaltrials.gov/ct2/show/NCT01356563 (first received 19 May 2011).
NCT01467050 2012 {unpublished data only}
    1. NCT01467050. Prevention of adverse drug events (ADEs) in hospitalised older patients. https://clinicaltrials.gov/ct2/show/NCT01467050 (first received 8 November 2011).
NCT01467128 2012 {unpublished data only}
    1. NCT01467128. Adverse drug event prevention using structured pharmacist review. https://clinicaltrials.gov/ct2/show/NCT01467128 (first received 8 November 2011).
NCT01503554 2011 {unpublished data only}
    1. NCT01503554. Combined social worker and pharmacist transitional care program. https://clinicaltrials.gov/show/NCT01503554 (first received 4 January 2012).
NCT01513265 2012 {unpublished data only}
    1. NCT01513265. Rationalisation of polypharmacy in the elderly by the RASP instrument. https://clinicaltrials.gov/ct2/show/NCT01513265 (first received 20 January 2012).
NCT01602744 2012 {unpublished data only}
    1. NCT01602744. The use of STOPP/START criteria for medication intervention among elderly population living in a geriatric hospital. https://clinicaltrials.gov/show/NCT01602744 (first received 21 May 2012).
NCT01627483 2010 {unpublished data only}
    1. NCT01627483. Randomized controlled trial of effects of physician's medication reviews on prescribing in older hip fracture patients. https://www.clinicaltrials.gov/ct2/show/NCT01627483 (first received 25 June 2012).
NCT01739816 2014 {unpublished data only}
    1. NCT01739816. Polymedication check - a randomised controlled trial. https://clinicaltrials.gov/ct2/show/NCT01739816 (first received 4 December 2012).
NCT01814280 2013 {unpublished data only}
    1. NCT01814280. Reducing medication errors on basis of an individual risk assessment. https://clinicaltrials.gov/ct2/show/NCT01814280 (first received19 March 2013).
NCT01906710 2013 {unpublished data only}
    1. NCT01906710. The Pharmacy Intervention Team Hospital-based (PITH) for People Study: effect on clinical and economic outcomes. https://clinicaltrials.gov/ct2/show/NCT01906710 (first received 24 July 2013).
NCT01969526 2016 {published data only}
    1. NCT01969526. Effectiveness of a multifactorial intervention on frailty. https://clinicaltrials.gov/ct2/show/NCT01969526 (first received 25 October 2013).
NCT02047448 2017 {unpublished data only}
    1. NCT02047448. Improving medication adherence through a transitional care pharmacy practice model. https://clinicaltrials.gov/ct2/show/NCT02047448 (first received 28 January 2014).
NCT02052505 2015 {unpublished data only}
    1. NCT02052505. Reducing inappropriate prescribing for psychiatric patients using nurse-led medication reviews. https://clinicaltrials.gov/ct2/show/NCT02052505 (first received 3 February 2014).
NCT02085837 2014 {unpublished data only}
    1. NCT02085837. Healthy transitions in late stage kidney disease. https://clinicaltrials.gov/ct2/show/NCT02085837 (first received 13 March 2014).
NCT02102503 2018 {unpublished data only}
    1. NCT02102503. Motivational interviewing and medication review in coronary heart disease. https://clinicaltrials.gov/ct2/show/NCT02102503 (first received 3 April 2014).
NCT02122965 2013 {unpublished data only}
    1. NCT02122965. The effect of medication review in high-risk emergency department patients. https://clinicaltrials.gov/ct2/show/NCT02122965 (first received 25 April 2014).
NCT02149940 2013 {published data only}
    1. NCT02149940. Feasibility of pharmaceutical interventions in elderly heart failure patients. https://clinicaltrials.gov/ct2/show/NCT02149940 (first received 29 May 2014).
NCT02165618 2014 {published data only}
    1. NCT02165618. Rationalisation of polypharmacy by the geriatric consultation team. https://www.clinicaltrials.gov/ct2/show/NCT02165618 (first received 17 June 2014).
NCT02202096 2016 {unpublished data only}
    1. NCT02202096. A pilot randomized trial of a comprehensive transitional care program for colorectal cancer patients. https://clinicaltrials.gov/ct2/show/NCT02202096 (first received 28 July 2014).
NCT02232126 2014 {unpublished data only}
    1. NCT02232126. Social work intervention focused on transitions (SWIFT). https://clinicaltrials.gov/show/NCT02232126 (first received 5 September 2014).
NCT02275572 2014 {unpublished data only}
    1. NCT02275572. Clinical and economical assessment of an intervention to reduce potentially inappropriate medication in polymedicated elderly patients (REMEI). https://clinicaltrials.gov/ct2/show/NCT02275572 (first received 27 October 2014).
NCT02317666 2015 {unpublished data only}
    1. NCT02317666. DBI - tool for medication reviews in older people. https://clinicaltrials.gov/ct2/show/NCT02317666 (first received 16 December 2014).
NCT02379455 2017 {unpublished data only}
    1. NCT02379455. Cooperation for improved pharmacotherapy in home-dwelling elderly people receiving polypharmacy- The COOP Study. https://clinicaltrials.gov/ct2/show/NCT02379455 (first received 5 March 2015).
NCT02598115 2016 {unpublished data only}
    1. NCT02598115. Impact of collaborative pharmaceutical care on hospital admission drug prescriptions for patients 65 years of age and older. https://clinicaltrials.gov/ct2/show/NCT02598115 (first received 5 November 2015).
NCT02664948 2015 {unpublished data only}
    1. NCT02664948. Early geriatric follow-up in older acute medical patients. https://clinicaltrials.gov/show/NCT02664948 (first received 27 January 2016).
NCT02712268 2013 {unpublished data only}
    1. NCT02712268. Intervention to improve prescribing in elderly patients. https://clinicaltrials.gov/ct2/show/NCT02712268 (first received 18 March 2016).
NCT02740764 2016 {unpublished data only}
    1. NCT02740764. Optimization of drug prescribing in an elderly population of geriatric consultations (OPTIM) [Optimization of drug prescribing in an elderly population of geriatric consultations and living at home]. https://clinicaltrials.gov/ct2/show/NCT02740764 (first received 15 April 2016).
NCT02871115 2019 {unpublished data only}
    1. NCT02871115. Pilot study of a pharmacy intervention for older adults with cancer. https://clinicaltrials.gov/ct2/show/NCT02871115 (first received 18 August 2016).
NCT02942927 2019 {unpublished data only}
    1. NCT02942927. Team approach to polypharmacy evaluation and reduction. https://clinicaltrials.gov/ct2/show/NCT02942927 (first received 24 October 2016).
NCT03123640 2017 {unpublished data only}
    1. NCT03123640. Drug safety in emergency patients - RTC on the effect of medication reconciliation and review on readmission rate. https://clinicaltrials.gov/show/NCT03123640 (first received 21 April 2017).
NCT03272607 2019 {unpublished data only}
    1. NCT03272607. Reducing post-discharge adverse drug events amongst the elderly: a multi-centre electronic deprescribing intervention. https://clinicaltrials.gov/ct2/show/NCT03272607 (first received 5 September 2017).
NCT03354845 2017 {unpublished data only}
    1. NCT03354845. Deprescribing of symptomatic medications in rehabilitative or subacute care patients. https://clinicaltrials.gov/show/NCT03354845 (first received 28 November 2017).
NCT03360305 2019 {unpublished data only}
    1. NCT03360305. GAPcare: the geriatric acute & post-acute care coordination program for fall prevention in the emergency department. https://clinicaltrials.gov/ct2/show/NCT03360305 (first received 4 December 2017).
NCT03369652 2017 {unpublished data only}
    1. NCT03369652. Telephone contact between hospital and general practitioner about medication review for older patients [Can telephone contact after discharge between geriatrician, clinical pharmacist and general practitioner about medication review in hospital improve the medication in older patients? A feasibility study]. https://clinicaltrials.gov/ct2/show/NCT03369652 (first received 12 December 2017).
NCT03369652 2018 {unpublished data only}
    1. NCT03369652. Telephone contact between hospital and general practitioner about medication review for older patients. https://clinicaltrials.gov/ct2/show/NCT03369652 (first received 12 December 2017).
NCT03445767 2018 {unpublished data only}
    1. NCT03445767. Structured polypharmacy management before elective non-cardiac surgery in frail and elderly people. https://clinicaltrials.gov/show/NCT03445767 (first received 26 February 2018).
NCT03557944 2019 {unpublished data only}
    1. NCT03557944. Team approach to polypharmacy evaluation and reduction (pharmacy). https://clinicaltrials.gov/ct2/show/NCT03557944 (first received 15 June 2018).
NCT03671629 2021 {unpublished data only}
    1. NCT03671629. Pharmacist intervention to reduce drug-related readmissions among the elderly. https://clinicaltrials.gov/ct2/show/NCT03671629 (first received 14 September 2018).
NCT03695081 2019 {unpublished data only}
    1. NCT03695081. Patient pathway pharmacist - optimal drug-related care. https://clinicaltrials.gov/ct2/show/NCT03695081 (first received 3 October 2018).
NCT03713112 2019 {unpublished data only}
    1. NCT03713112. Efficacy and feasibility of de-prescribing rounds in a Singapore rehabilitative hospital- a pilot randomized controlled trial. https://clinicaltrials.gov/ct2/show/NCT03713112 (first received 19 October 2018).
NCT03722017 2021 {unpublished data only}
    1. NCT03722017. Drug Reduction in Older Patients: the DROP trial. https://clinicaltrials.gov/ct2/show/NCT03722017 (first received 26 October 2018).
NCT03750500 2018 {unpublished data only}
    1. NCT03750500. Clinical impact of a digital home-based falls prevention program on elderly people. https://clinicaltrials.gov/ct2/show/NCT03750500 (first received 23 November 2018).
NCT03824106 2023 {published data only}
    1. NCT03824106. Frailty rehabilitation. https://clinicaltrials.gov/ct2/show/NCT03824106 (first received 31 January 2019).
NCT03902028 2021 {unpublished data only}
    1. NCT03902028. Optimized medico-pharmaceutical collaboration in the drug management of patients with heart failure. https://clinicaltrials.gov/ct2/show/NCT03902028 (first received 3 April 2019).
NCT03909035 2021 {unpublished data only}
    1. NCT03909035. A collaborative approach to medication reviews for older patients with polypharmacy. https://clinicaltrials.gov/ct2/show/NCT03909035 (first received 9 April 2019).
NCT03922529 2019 {unpublished data only}
    1. NCT03922529. Modified application of cardiac rehabilitation for older adults. https://clinicaltrials.gov/ct2/show/NCT03922529 (first received 22 April 2019).
NCT04077281 2019 {unpublished data only}
    1. NCT04077281. Improving medication prescribing-related outcomes for vulnerable elderly in transitions. https://clinicaltrials.gov/show/NCT04077281 (first received 4 September 2019).
NCT04082871 2019 {unpublished data only}
    1. NCT04082871. Medication review in women with depression and anxiety. https://clinicaltrials.gov/ct2/show/NCT04082871 (first received 9 September 2019).
NCT04087109 2020 {unpublished data only}
    1. NCT04087109. MedSafer e-care: an automated deprescribing solution (E-CARE Study). https://clinicaltrials.gov/ct2/show/NCT04087109 (first received 12 September 2019).
NCT04151797 2019 {unpublished data only}
    1. NCT04151797. Impact of a mobile geriatric team with a pharmacist on the optimisation of prescriptions in elderly inpatients (PHARMOG). https://clinicaltrials.gov/ct2/show/NCT04151797 (first received 5 November 2029).
NCT04188470 2019 {unpublished data only}
    1. NCT04188470. Optimising drug therapy in polymedicated patients according to the person-centered care model [Open randomised multicentric controlled trial to evaluate the impact of an intervention to improve drug appropriateness in polymedicated patients according to the person-centered care model by a multidisciplinary team at primary care]. https://clinicaltrials.gov/ct2/show/NCT04188470 (first received 6 December 2019).
NCT04228900 2020 {unpublished data only}
    1. NCT04228900. Malnutrition in older adults: an intervention based on medication review and individual nutritional plan [Nutrition and medication management in home-dwelling older adults. Study II: malnutrition in older adults: an intervention based on medication review and individual nutritional plan]. https://clinicaltrials.gov/ct2/show/NCT04228900 (first received 14 January 2020).
NCT04251520 2020 {unpublished data only}
    1. NCT04251520. The role of the pharmacist and pharmacogenomics in the care of seriously ill patients. https://clinicaltrials.gov/ct2/show/record/NCT04251520 (first received 5 February 2020).
NCT04278794 2020 {unpublished data only}
    1. NCT04278794. Optimizing hospital-to-home transitions for older adults with stroke and multimorbidity [Optimizing hospital-to-home transitions for older adults with stroke and multimorbidity: a pragmatic trial of an outpatient-based virtual transitional care intervention]. https://clinicaltrials.gov/ct2/show/record/NCT04278794 (first received 20 February 2020).
NCT04360746 2020 {unpublished data only}
    1. NCT04360746. The influence of clinical pharmacist on the quality of drug prescribing and rehabilitation outcomes in post-acute hip fractured patients. https://clinicaltrials.gov/ct2/show/NCT04360746 (first received 24 April 2020).
NCT04391218 2020 {unpublished data only}
    1. NCT04391218. A multidisciplinary intervention including a clinical decision support system and an app for drug therapy management in older patients (FARMA-CANP). https://clinicaltrials.gov/ct2/show/NCT04391218 (first received 18 May 2020).
NCT04417400 2020 {unpublished data only}
    1. NCT04417400. Evaluation of medicines use review in Slovenia (SLOPUZ) [Benefits of medicines use review service in Slovenia: a randomized controlled trial]. https://clinicaltrials.gov/ct2/show/NCT04417400 (first received 4 June 2020).
NCT04553107 2020 {unpublished data only}
    1. NCT04553107. Reducing costs by deprescribing medications [Reducing healthcare costs in older adults by deprescribing unnecessary, harmful, and costly medications]. https://clinicaltrials.gov/ct2/show/NCT04553107 (first received 17 September 2020).
NCT04556786 2020 {unpublished data only}
    1. NCT04556786. A pharmacist-led transitions of care program [The impact of a pharmacist-led transitional care program on health outcomes of uninsured populations]. https://clinicaltrials.gov/ct2/show/NCT04556786 (first received 21 September 2020).
NCT04722588 2021 {unpublished data only}
    1. NCT04722588. Integrating the clinical pharmacists into emergency department teams (ED-PHARM) [Integrating the clinical pharmacist into the emergency department interdisciplinary team: a study protocol for a multicentre trial applying a non-randomized stepped wedge study design]. https://clinicaltrials.gov/ct2/show/NCT04722588 (first received 25 January 2021). - PMC - PubMed
NCT04796701 2021 {unpublished data only}
    1. NCT04796701. Effect of a transitional care intervention [Effect of a transitional care intervention from hospital to home on readmissions among older medical patients: a quasi-experimental study]. https://clinicaltrials.gov/ct2/show/record/NCT04796701 (first received 15 March 2021).
Nymoen 2019 {published data only}
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    1. NCT01467128. Adverse drug event (ADE) incidence in older patients following hospital admission and pharmacist review to older persons' prescriptions and its' effect on ADE reduction in hospital: a randomised controlled trial. www.clinicaltrials.gov/show/NCT01467128 (first received 8 November 2011).
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Pazan 2018 {published data only}
    1. Pazan F, Burkhardt H, Frohnhofen H, Weiss C, Throm C, Kuhn-Thiel A, et al. Changes in prescription patterns in older hospitalized patients: the impact of FORTA on disease-related over- and under-treatments. European Journal of Clinical Pharmacology 2018;74(3):339-47. - PubMed
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    1. Pope G, Wall N, Peters CM, O'Connor M, Saunders J, O'Sullivan C, et al. Specialist medication review does not benefit short-term outcomes and net costs in continuing-care patients. Age & Ageing 2011;40(3):307–12. [PMID: ] - PubMed
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    1. Santolaya-Perrin R, Calderon-Hernanz B, Jimenez-Diaz G, Galan-Ramos N, Moreno-Carvajal MT, Rodriguez-Camacho JM, et al. The efficacy of a medication review programme conducted in an emergency department. International Journal of Clinical Pharmacy 2019;41(3):757-66. - PubMed
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    1. Schmader KE, Hanlon JT, Pieper CF, Sloane R, Ruby CM, Twersky J, et al. Effects of geriatric evaluation and management on adverse drug reactions and suboptimal prescribing in the frail elderly. American Journal of Medicine 2004;116(6):394-401. [PMID: ] - PubMed
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SLCTR//011 2018 {unpublished data only}
    1. SLCTR//011. Clinical pharmacy services to improve management outcomes of chronic kidney disease of uncertain etiology patients undergoing hemodialysis. http://www.who.int/trialsearch/Trial2.aspx?TrialID=SLCTR/2018/011 2018.
SLCTR//029 2013 {unpublished data only}
    1. SLCTR//029. Impact of a ward based clinical pharmacist on improving the quality use of medicines in patients with chronic non communicable diseases, compared to standard practice in a Sri Lankan teaching hospital. http://www.who.int/trialsearch/Trial2.aspx?TrialID=SLCTR/2013/029 2013.
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    1. Smith DM, Cox MR, Brizendine EJ, Hui SL, Freedman JA, Martin DK, et al. An intervention on discharge polypharmacy. Journal of the American Geriatrics Society 1996;44(4):416-9. [PMID: ] - PubMed
Spinewine 2007 {published data only (unpublished sought but not used)}
    1. Spinewine A, Swine C, Dhillon S, Lambert P, Nachega JB, Wilmotte L, et al. Effect of a collaborative approach on the quality of prescribing for geriatric inpatients: a randomized, controlled trial. Journal of the American Geriatrics Society 2007;55(5):658-65. [PMID: ] - PubMed
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    1. Tallon M, Barragry J, Allen A, Breslin N, Deasy E, Moloney E, et al. Impact of the collaborative Pharmaceutical Care at Tallaght Hospital (PACT) model on medication appropriateness of older patients. European Journal of Hospital Pharmacy: Science & Practice 2016;23(1):16-21. - PMC - PubMed
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    1. Tan PJ, Khoo EM, Chinna K, Saedon NI, Zakaria MI, Ahmad Zahedi AZ, et al. Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): a randomized controlled trial. PLOS One 2018;13(8):e0199219. - PMC - PubMed
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NCT03666793 2018 {unpublished data only}
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NCT04028583 2019 {unpublished data only}
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NCT04617340 {published data only}
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References to other published versions of this review

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Publication types