Fumihiro Mizokami1, Tomohiro Mizuno2,3, Koichiro Kanamori2, Sakiko Oyama2, Tadashi Nagamatsu2, Jeannie K Lee4, Tomoharu Kobayashi1. 1. Department of Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan. 2. Analytical Pharmacology, Meijo University Graduate School of Pharmacy, Nagoya, Japan. 3. Center for Innovation in Clinical Pharmacy Education and Research, Meijo University, Nagoya, Japan. 4. Department of Pharmacy Practice & Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA.
Abstract
AIM: To analyze the impact of clinical medication reviews (CMR) on reducing unplanned hospitalizations owing to polypharmacy among older adults using an intervention. METHODS: Our meta-analysis complied with PRISMA guidelines. The literature review comprised a search for articles published between January 1972 and March 2017 on MEDLINE and Google Scholar. We identified randomized controlled trials focusing on CMR that evaluated unplanned hospitalization and re-hospitalization among older adults as a primary outcome. The keywords used were "CMR" or "medication review" in their titles, and the phrases "elderly" or "older adults" or "geriatric" and "polypharmacy." The randomized controlled trials selected were divided according to the three types of CMR to analyze the characteristics of each review. RESULTS: We included nine randomized controlled trials that examined the impact of CMR of polypharmacy in older patients. Five trials corresponded to CMR type I (prescription only review) or II (adherence review), whereas four corresponded to type III (comprehensive clinical evaluation for disease management). Type I/II increased the number of unplanned hospitalizations (RR 1.22, 95% CI 1.07-1.38, P = 0.002), whereas type III decreased hospital admissions (RR 0.86, 95% CI 0.79-0.95, P = 0.001). CONCLUSIONS: The present findings show the need for an intervention standardization for CMR, particularly for type III in older adults with polypharmacy, to decrease hospitalizations. Geriatr Gerontol Int 2019; 19: 1275-1281.
AIM: To analyze the impact of clinical medication reviews (CMR) on reducing unplanned hospitalizations owing to polypharmacy among older adults using an intervention. METHODS: Our meta-analysis complied with PRISMA guidelines. The literature review comprised a search for articles published between January 1972 and March 2017 on MEDLINE and Google Scholar. We identified randomized controlled trials focusing on CMR that evaluated unplanned hospitalization and re-hospitalization among older adults as a primary outcome. The keywords used were "CMR" or "medication review" in their titles, and the phrases "elderly" or "older adults" or "geriatric" and "polypharmacy." The randomized controlled trials selected were divided according to the three types of CMR to analyze the characteristics of each review. RESULTS: We included nine randomized controlled trials that examined the impact of CMR of polypharmacy in older patients. Five trials corresponded to CMR type I (prescription only review) or II (adherence review), whereas four corresponded to type III (comprehensive clinical evaluation for disease management). Type I/II increased the number of unplanned hospitalizations (RR 1.22, 95% CI 1.07-1.38, P = 0.002), whereas type III decreased hospital admissions (RR 0.86, 95% CI 0.79-0.95, P = 0.001). CONCLUSIONS: The present findings show the need for an intervention standardization for CMR, particularly for type III in older adults with polypharmacy, to decrease hospitalizations. Geriatr Gerontol Int 2019; 19: 1275-1281.
Authors: Thomas G H Kempen; Maria Bertilsson; Nermin Hadziosmanovic; Karl-Johan Lindner; Håkan Melhus; Elisabet I Nielsen; Johanna Sulku; Ulrika Gillespie Journal: JAMA Netw Open Date: 2021-04-01
Authors: Thomas Grischott; Yael Rachamin; Oliver Senn; Petra Hug; Thomas Rosemann; Stefan Neuner-Jehle Journal: J Gen Intern Med Date: 2022-08-31 Impact factor: 6.473