Effectiveness of Pharmacist Intervention to Reduce Medication Errors and Health-Care Resources Utilization After Transitions of Care: A Meta-analysis of Randomized Controlled Trials

Abstract

Objectives: Medication errors are common during transitions of care.The main objective of the current investigation was to examine the effectiveness of pharmacist-based transition of care interventions on the reduction of medication errors after hospital discharge. Methods:A systematic search was conducted to detect published reports of randomized trials using the National Library of Medicine's PubMed database, the Cochrane Database of Systematic Reviews, and Google Scholar inclusive to July 1, 2015. Search terms included pharmacist, medication, errors, readmission, transition, and discharge. A priori main outcomes included medication errors and health-care resources utilization (hospital readmission and/or emergency room visits). Quantitative analysis was performed using a random effect method.Results: Thirteen randomized trials examining 3503 patients were included in the final analysis. The aggregate effect of the 10 studies evaluating the effect of pharmacists intervention on the incidence of medication errors during transitions of care favored pharmacist over control with an odds ratio (95% confidence interval [CI]) of 0.44 (0.31-0.63). The overall effect of 4 studies evaluating the effect of a pharmacist intervention on the incidence of emergency room visits compared with control favored the pharmacist intervention, odds ratio (95% CI) of 0.42 (0.22-0.78), number needed to treat (95% CI) of 6.2 (3.4-31.4).Conclusions: Pharmacist transition of care intervention is an effective strategy to reduce medication errors after hospital discharge. In addition, a pharmacist intervention also reduces subsequent emergency room visits. Hospitals should consider implementing this intervention to improve patient safety and quality during transitions of care.

The impact of community pharmacist involvement on transitions of care: A systematic review and meta-analysis

“…Our study's findings match those of other recent systematic reviews. 7,11,[57][58][59][60] Rodrigues et al 7 examined the effect of pharmacy-supported transitions of care interventions and Community pharmacists and transitions: A systematic review found a 32% reduction in 30-day readmissions (odds ratio 0.68; 95% CI 0.61-0.75), 7 and Mekonnen et al 58 examined the impact of medication reconciliation programs at transitions of care and found a 19% reduction in readmissions (RR, 0.81; 95% CI 0.70-0.95) 58 ; however, neither study was focused on community pharmacy. McNab et al 60 examined community pharmacist involvement on medication reconciliation, but not exclusively, and found a 9% reduction in readmissions (RR, 0.91; 95% CI 0.66-1.25).…”

Current situation of medication errors in Saudi Arabia: a nationwide observational study

“…The role of pharmacists has been shown to be critical in reducing medication errors. For instance, a meta-analysis of 13 studies found that pharmacist intervention led to a 37% reduction in medication errors [26].…”

Impact of a transitions of care pilot service established by pharmacy residents within an academic medical center

“…A metaanalysis of randomized controlled trials revealed that pharmacist-based interventions substantially decreased the number of medication-related problems and subsequent emergency department (ED) visits but could not decrease hospital readmission rates. 9 More recently, a large randomized trial was published that compared usual discharge care with pharmacist discharge medication review or extensive intervention (discharge medication review plus motivational interviewing and pharmacist involvement in primary care appointment). This study revealed that both 30-and 180-day ED visits and readmissions were substantially decreased in the extensive care arm compared with the usual care or discharge medication reconciliation only arms.…”