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Unplanned hospital admissions among older adults with heart failure may be reduced by pharmacist-led education and follow-up interventions

Thomas R, Huntley AL, Mann M, et al.  Pharmacist-led interventions to reduce unplanned admissions for older people: A systematic review and meta-analysis of randomised controlled trials Age and Ageing. 2014;43(3):174-187.

Review question

What is the impact of interventions led by pharmacists on reducing unplanned hospital admissions among older adults?

Background

Adults over the age of 60 who are using multiple medications may be at greater risk of medication-related problems (e.g. adverse reactions, interactions and poor adherence), which are thought to cause between 10 and 30% of all hospital admissions in this age group.

Engaging pharmacists to play a key role in medication reviews, as well as in the prevention, identification and reporting of medication errors, may encourage the effective use of medicine and reduce medicine-related problems such as unplanned hospital admissions.

How the review was done

A wide range of electronic databases were searched for research conducted up to and including June 2010, and studies were included  in the review if they focused on pharmacist-led interventions, and on reductions in unplanned hospital admissions (or readmissions) in older people. .

27 studies were identified in searches, and 20 were included in the review after being assessed against the inclusion criteria.

The review was funded by the National Institute for Health Research under Research for Patient Benefit program.

What the researchers found

There was little evidence to suggest that pharmacist-led interventions (whether by community-based or hospital-based pharmacists) reduced unplanned hospital admissions among the general population of older adults.

Three of the included studies showed that pharmacist-led education interventions prior to hospital discharge in combination with follow-up after discharge were found to reduce the risk of unplanned admissions by 25% among older adults with heart failure.

Additional high quality research is needed to confirm the findings of this review.

Conclusion

Pharmacist-led interventions, such as education and follow-up care, show promise for reducing unplanned hospital admissions among older adults with heart failure.

This summary is based on a review that was determined to be of medium methodological quality based on an assessment using the AMSTAR tool.