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Table 1 Study characteristics of the included studies

From: Effectiveness of medication review: a systematic review and meta-analysis of randomized controlled trials

Author (Year)

Risk of bias

Foll-ow up (mos.)

Country and setting

Mean age (IG), years

No. Pts.

Description intervention

Patient selection criteria for medication review

HCP involvement

R: Medication review

D: Decision about clinical relevancy

Patient Involve-ment

Nr assess-ments/nr patient contacts

Additional

Education

HCP

Age, years

Nr drugs

Other

Bond [38] (2007)

LRB

12

GB, general practices

Nr

2014

R: Pharmacist

D: GP

No

1

Yes

< 65 a

No

Specific conditionsa

Briggs [73] (2015)

HRB

4

AU, tertiary referral hospital

82.0

2015

R: Hospital pharmacist

D: GP

Yes

1

Nr

>70a

>5a

Living at homea

Britton [51] (1991)

HRB

3

US, general medicine clinic

Nr

760

R: Clinical pharmacist

D: physician (assistant)

No

1

Yes

No

> 5

No

Burns [32]/Furniss [42] (2000)

HRB

4

GB, nursing homes

83.5

330

R: (study) pharmacist

D: multidisciplinary team

No

2

Nr

No

No

Living in nursing home

Gallagher [49] (2011)

LRB

6

GB, tertiary medical centre

74.5

400

R: (research) physician, medical team

D: physician

No

1

Nr

≥ 65a

No

Emergency admissiona

Graffen [74] (2004)

HRB

6

AU, general practices

Nr

402

R: Pharmacist

D: GP and patient

Yes

1

Nr

> 65a

≥ 5a

Living independentlya; ≥ 1 of followinga: use of predefined risk drugs; > 12 doses per day; > 6 diagnoses; BMI < 22

Heselmans [33] (2015)

HRB

0b

BE, general and specialized hospitals

66.6

600

R: Pharmacist

D: Ward physician

No

1

Nr

>15a

No

ICU stay of at least three consecutive daya

Holland [34] (2005)/Pacini [53] (2007)

LRB

6

GB, emergency wards

85.4

855

R: (study) pharmacist

D: pharmacist or GP

Yes

2

Yes

> 80a

≥ 2a

Discharged after emergency admission to own home or warden controlled accommodationa

Jameson [47] (1995)

HRB

6

US, family health center

Nr

64

R: Clinical pharmacist

D: Physician and pharmacist

Yes

2

Nr

No

≥ 5 (see other)

≥ 2 of following risk factors: ≥ 5 drugs; ≥ 12 daily doses; ≥ 4 medication changes last 12 months.; >3 concurrent diseases; noncompliance; drugs requiring TDM

Jameson [50] (2001)

HRB

6

US, private physicians

51.4

340

R: Clinical pharmacist

D: Physician and pharmacist

Yes

1

Nr

No

≥ 5

No

Krska [75] (2001)

HRB

3

GB, medical practices

74.8

381

R: Clinical pharmacist

D: GP and pharmacist

Yes

1

Nr

≥ 65a

≥ 4a

≥ 2 chronic conditionsa

Kwint [76] (2011)

LRB

6

NL, community pharmacies

78.7

118

R: 2 research pharmacists

D: GP and community pharmacist

No

1

Nr

≥ 65a

≥ 5a

living at homea; at least one drug had to be dispensed via an automated systema

Lenaghan [77] (2007)

HRB

6

GB, general practices

84.5

136

R: study-pharmacist

D: GP and study- pharmacist

Yes

2

Nr

> 80a

≥ 4a

living in own homesa; ≥ 1 of following criteriaa: living alone; confused mental state, vision or hearing impairment; prescribed medicines associated with medication-related morbidity; prescribed >7 regular oral medicines

Lenander [35] (2014)

HRB

12

SE, primary care centre

79.0

209

R: Geriatrics pharmacist

D: GP and patient

Yes

1

No

> 65a

≥ 5a

already scheduled for an appointment with a GPa

Lim [41] (2004)

LRB

2

SG, geriatric outpatient clinic

79.6

126

R: pharmacist (of a pharmacist consult clinic)

D: primary physician

Yes

1

Nr

No

> 3 (see other)

≥ 1 of following criteria: TDM required; polypharmacy (>3 drugs or >9 doses per day); non-compliance; self-administered drugs that require psychomotor skill and co-ordination; nasogastric tube feeding; >1 doctor managing care; hospitalized within the last 6 months.

Lisby [36] (2010)

LRB

3

DK, acute ward

80.2

100

R: Clinical pharmacist and a clinical pharmacologist

D: ward physicians

Yes

2

Nr

≥ 70a

≥ 1a

expected to be admitted for more than 24 ha

Lisby [30] (2015)

LRB

3

DK, regional hospital

80.4

108

R: Clinical pharmacist and a clinical pharmacologist

D: Orthopedic ward physicians

Yes

2

Nr

> 65a

≥ 4a

nonelective admission at orthopedic warda; expected in-hospital length of stay (LOS) of a minimum of 24 hoursa

Mannheimer [78] (2006)

LRB

6

SE, clinical internal medicine

71.0

305

P: nurse and clinical pharmacologist

D: physician in charge

Yes

1

Nr

No

≥ 2a

patients who had been in hospital for < 24 h on Tue. to Fri. or for < 60 h on Mon. before a nurse screened the computerized medical recorda

Meredith [45] (2002)

LRB

1.5

US, home care

80.3

317

P: nurse and clinical pharmacist

D: Physician

Yes

1

Yes

≥ 65a

No

had ≥ 1 of the four possible study medication problemsa; projected duration of home health care of ≥4 wksa

Meyer [79] (1991)

HRB

12

US, VAMC

Nr

312

R: study-physician (Group III, intensive intervention)

D: Physicians and nurse practitioners

No

1

Nr

No

≥ 10

being followed by providers at the medical center

Michalek [39] (2014)

LRB

0b

DE, tertiary medical center

84c

114

R: Physicians

D: Physicians

No

1

Nr

> 70a

≥ 3a

admitted to the acute geriatric unita, stable health condition defined as no need for intermediate or intensive care unit treatmenta, had at least three diseases in need for drug treatmenta.

Milos [80] (2013)

LRB

2

SE, primary health care centres

87.0

374

R: Clinical pharmacist

D: Physician

No

1

Yes

≥ 75a

No

users of the multi-dose drug dispensing system; living in nursing homes or their own homes with municipally provided home care

Olsson [46] (2012)

HRB

12

SE, primary care

83.4

150

R: study-physician

D: Family physician

Yes

1

Nr

≥ 75a

≥ 5a

living in ordinary homesa

Pit [44] (2007)

HRB

12

AU, general practice

Nr

849

R: Doctors

D: Doctors

Yes

1

Yes

≥ 65a

No

living in the communitya

Pope [43] (2011)

LRB

6

GB, community hospitals

83.3

225

R: multidisciplinary panel

D: General practitioner

No

1

Nr

No

No

permanent patients on the continuing-care wards

Sellors [52] (2001)

LRB

6

CA, family physician practice

76.4

132

R: study-pharmacist

D: family physician

Yes

1

Yes

≥ 65a

≥ 4a

No

Sellors [37] (2003)

LRB

5

CAN, family physician practices

74.0

889

R: Pharmacist

D: Physician

Yes

1

Nr

≥ 65a

≥ 5a

had been seen by their physician within; the past 12 monthsa; no evidence of cognitive impairment; could understand English.

Williams [40] (2004)

HRB

1.5

US, general medicine clinic

73.5

140

R: Interdisciplinary team (consultant pharmacist, physician and nurse)

D: Primary physician

Yes

1

Nr

≥ 65a

≥ 5a

≥ 2 of the medications were potentially problematic drugs for common geriatric problemsa; cognitively intact a

Zermansky [48] (2001/2002)

LRB

12

GB, general practices

74.0

1188

R: Study-clinical pharmacist

D: Pharmacist or GP

Yes

1

Nr

≥ 65a

≥ 1a

No

Zermansky [81] (2006)

LRB

6

GB, care homes

85.3

661

R: Study-clinical pharmacist

D: GP

Yes

1

Nr

≥ 65a

≥ 1a

No

Zillich [31] (2014)

LRB

2

US, home health care centers

73.0

895

R: Pharmacist

D: Patient, pharmacist, physician

Yes

3–4

Nr

No

No

All new patients admitted into Medicare’s defined 60-day home health care episode were eligible. Medicare eligibility for home health benefits requires ordering services by a physician who reviews the need for a patient’s care and certifies that the patient is homebound

  1. mos. months, IG intervention group, Pts. patients, HCP healthcare professional, LRB low risk of bias, HRB high risk of bias, a combination of inclusion criteria (= “and”), Nr not reported, boutcome measures determined directly after discharge from ICU and/or discharge from hospital, TDM therapeutic drug monitoring, hr hours, cmedian, VAMC Veterans Affairs Medical Center