French study finds evidence that hospital medication reviews may have a positive impact – but overall evidence remains flimsy
Researchers from the Hôpitaux de Marseille, France, conducted a systemic review and meta-analysis of 19 randomised controlled trials that looked at pharmacist-led medication reviews in hospital.
Analysis of the data, comprising 4805 patients, suggested that readmission rates were similar between experimental and control groups, except where drug-related readmissions were concerned.
Here, there was a lower relative risk in the intervention group when compared with the control group. All-cause ED trips were also lower.
The study also found that clinical medication reviews and adherence reviews had an impact on adherence.
“Pharmacist-led medication reviews were associated with a decrease in the number of ED visits and drug-related readmissions,” say the authors.
“The impact of medication reviews on the length of hospital stay and adherence remains unclear. Based on the results of this meta-analysis and other meta-analyses, it seems very unlikely, as might be expected, that medication reviews have an impact on mortality.
“However, the impact on patient quality of life may be more in question; indeed, the variety of the assessments used did not enable us to determine any effects.”
The researchers point out the evidence in their study is low quality, and “more high-quality randomised clinical trials are needed to assess the impact of pharmacist-led medication reviews on patient-relevant outcomes, including adherence and quality of life.”
A randomised controlled trial with a large number of subjects, using a standardised medication review in populations at risk for drug-related readmission, is necessary to gain more understanding of its impact, they conclude.