Effect of medication reconciliation interventions on outcomes: A systematic overview of systematic reviews

被引：25

作者：

Anderson, Laura J. ^{[1
]}

Schnipper, Jeff L. ^{[2
]}

Nuckols, Teryl K. ^{[1
]}

Shane, Rita ^{[3
]}

Le, Michael M. ^{[4
]}

Robbins, Karen ^{[1
]}

Pevnick, Joshua M. ^{[1
,5
]}

Hughes, Carmel ^{[6
]}

Jackevicius, Cynthia A. ^{[7
,8
]}

O'Mahony, Denis ^{[9
]}

Sarkisian, Catherine ^{[10
]}

机构：

[1] Cedars Sinai Med Ctr, Dept Med, Los Angeles, CA 90048 USA

[2] Brigham & Womens Hosp, Dept Med, 75 Francis St, Boston, MA 02115 USA

[3] Cedars Sinai Med Ctr, Dept Pharm, Los Angeles, CA 90048 USA

[4] David Geffen Sch Med, Los Angeles, CA USA

[5] PHARM DC Grp, Los Angeles, CA USA

[6] Queens Univ Belfast, Sch Pharm, Belfast, Antrim, North Ireland

[7] Western Univ Hlth Sci, Dept Pharm Practice & Adm, Pomona, CA USA

[8] VA Greater Angeles Healthcare Syst, Los Angeles, CA USA

[9] Univ Coll Cork, Dept Geriatr Med, Cork, Ireland

[10] Univ Calif Los Angeles, David Geffen Sch Med, Div Geriatr, Los Angeles, CA 90095 USA

来源：

AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY | 2019年 / 76卷 / 24期

基金：

美国国家卫生研究院;

关键词：

intervention; medication reconciliation; medication errors; medication review; review; systematic review; CARE; TRANSITIONS; DISCREPANCIES; PHARMACISTS; QUALITY;

D O I：

10.1093/ajhp/zxz236

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Purpose. To evaluate and summarize published evidence from systematic reviews examining medication reconciliation. Methods. MEDLINE, the Cochrane Database of Systematic Reviews, and the Database of Abstracts of Reviews of Effects were searched for English-language systematic reviews published from January 2004 to March 2019. Reviewers independently extracted information and scored review quality using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. For reviews with AMSTAR scores above 7, Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was applied to assess evidence quality, with evidence summarized and conclusions compared across reviews. Results. Eleven reviews met the inclusion criteria, 5 of which used meta-analytic pooling. Most systematic reviews included primary studies of comprehensive bundled interventions that featured medication reconciliation as a central component. Reviews largely focused on transitions into and out of hospital settings. Five reviews focused exclusively on pharmacist-led interventions. Of the 5 reviews that considered all types of medication discrepancies, 3 reviews found very low-quality evidence that interventions reduced medication discrepancies. Neither of the 2 reviews that examined clinically significant medication discrepancies found any intervention effect. Of the 5 reviews that examined healthcare utilization outcomes, only 1 found any intervention effect, and that finding was based on low- to very low-quality evidence. Four reviews considered clinical outcomes, but none found any intervention effect. Conclusion. An overview of systematic reviews of medication reconciliation interventions found 9 high-quality systematic reviews. A minority of those reviews' conclusions were consistent with medication reconciliation alone having a measurable impact, and such conclusions were almost all based on very low-quality evidence.

引用

页码：2028 / 2040

页数：13

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