Medication reviews carried out by hospital pharmacists can reduce drug-related readmissions and emergency department (ED) visits but the evidence behind these services is of poor quality, according to a study.
Researchers conducted a systematic review and meta-analysis of 19 randomised controlled trials that examined the impact of pharmacist-led medication reviews in the hospital setting. The available data on 4,805 patients suggest that readmission rates did not differ between experimental and control groups, except for drug-related readmissions, which had a lower relative risk (RR) in the intervention group compared with the control group (RR=0.25, 95% confidence interval [CI] 0.14–0.45; P<0.001), and for all-cause ED visits (RR=0.70, 95% CI 0.59–0.85; P=0.001).
“Our study found no significant reductions in the rate of all-cause readmissions and/or emergency department visits due to pharmacist-led medication reviews in hospitals,” says Pierre Renaudin, a researcher at the HÃ´pitaux de Marseille, France, and colleagues in the British Journal of Clinical Pharmacology
 (online, 29 September 2016). “However, pharmacist-led medication reviews were associated with a decrease in the number of ED visits and drug-related readmissions.”
David Wright, professor of pharmacy practice at the school of pharmacy at the University of East Anglia, describes the findings as “dispiriting” but adds that “the result… is no different to any other systematic review of the clinical effectiveness of medication review by pharmacists”.
Wright adds that unless information is successfully transferred to primary care and the patient actually takes the medicines then the review of therapeutic appropriateness is unlikely to have any effect.
 Renaudin P, Boyer L, Esteve M-A et al. Do pharmacist-led medication reviews in hospitals help reduce hospital readmissions? A systematic review and meta-analysis. British Journal of Clinical Pharmacology 2016. doi: 10.1111/bcp.13085