TY - JOUR
T1 - Effect of medication reconciliation interventions on outcomes
T2 - A systematic overview of systematic reviews
AU - Anderson, Laura J.
AU - Schnipper, Jeff L.
AU - Nuckols, Teryl K.
AU - Shane, Rita
AU - Le, Michael M.
AU - Robbins, Karen
AU - Pevnick, Joshua M.
AU - Hughes, Carmel
AU - Jackevicius, Cynthia A.
AU - O'Mahony, Denis
AU - Sarkisian, Catherine
N1 - Publisher Copyright:
© 2019 American Society of Health-System Pharmacists 2019. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2019/12/2
Y1 - 2019/12/2
N2 - 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.
AB - 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.
KW - intervention
KW - medication errors
KW - medication reconciliation
KW - medication review
KW - review
KW - systematic review
UR - https://www.scopus.com/pages/publications/85076021542
U2 - 10.1093/ajhp/zxz236
DO - 10.1093/ajhp/zxz236
M3 - Article
C2 - 31789354
AN - SCOPUS:85076021542
SN - 1079-2082
VL - 76
SP - 2028
EP - 2040
JO - American Journal of Health-System Pharmacy
JF - American Journal of Health-System Pharmacy
IS - 24
ER -