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 |
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 |
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 |