Medication review in hospitalised patients to reduce morbidity and mortality

Cochrane Database of Systematic Reviews

Volumn 2016, Issue 2, 2016, Pages

  Christensen, Mikkel ^a   Lundh, Andreas ^b  

^a BISPEBJERG HOSPITAL   (Denmark)

^b Rigshospitalet   (Denmark)

Author keywords

[No Author keywords available]

Indexed keywords

ADVERSE DRUG REACTION; CINAHL; COCHRANE LIBRARY; EMBASE; EMERGENCY WARD; HEALTH CARE MANAGEMENT; HEALTH CARE PERSONNEL; HOSPITAL PATIENT; HOSPITAL READMISSION; HUMAN; INFORMATION RETRIEVAL; MEDICATION REVIEW; MEDLINE; MORBIDITY; MORTALITY; OUTCOME ASSESSMENT; PHARMACIST; PHYSICIAN; QUALITY CONTROL; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; SYSTEMATIC REVIEW; AGED; CAUSE OF DEATH; EMERGENCY HEALTH SERVICE; HEALTH CARE QUALITY; MEDICATION THERAPY MANAGEMENT; MIDDLE AGED; POLYPHARMACY; STATISTICS AND NUMERICAL DATA; UTILIZATION; VERY ELDERLY;

AGED; AGED, 80 AND OVER; CAUSE OF DEATH; EMERGENCY SERVICE, HOSPITAL; HUMANS; INPATIENTS; MEDICATION RECONCILIATION; MIDDLE AGED; PATIENT READMISSION; POLYPHARMACY; RANDOMIZED CONTROLLED TRIALS AS TOPIC; STANDARD OF CARE;

EID: 84962156826     PISSN: None     EISSN: 1469493X     Source Type: Journal    
DOI: 10.1002/14651858.CD008986.pub3     Document Type: Review

References (119)

1. Bladh L, Ottosson E, Karlsson J, Klintberg L, Wallerstedt SM. Effects of a clinical pharmacist service on health-related quality of life and prescribing of drugs: a randomised controlled trial. BMJ Quality & Safety 2011;20(9):738-46. [PUBMED: 21209140]
2. Bonnerup DK, Lisby M, Sædder EA, Brock B, Truelshøj T, Sørensen CA, et al. Effects of stratified medication reviews in high-risk patients at admission to hospital: a randomised controlled trial. Risk Stratification of Medication Reviews: Physicians' Perspectives, Test of Algorithm and Interventions [PhD Thesis by Dorthe Bonnerup]. Aarhus, Denmark: Faculty of Health Sciences, Aarhus University, 2014:82-100.
3. Dalleur O, Boland B, Losseau C, Henrard S, Wouters D, Speybroeck N, et al. Reduction of potentially inappropriate medications using the STOPP criteria in frail older inpatients: a randomised controlled study. Drugs & Aging 2014;31(4):291-8. [PUBMED: 24566877]
4. Farris KB, Carter BL, Xu Y, Dawson JD, Shelsky C, Weetman DB, et al. Effect of a care transition intervention by pharmacists: an RCT. BMC Health Services Research 2014;14:406. [PUBMED: 25234932]
5. Gallagher PF, O'Connor MN, O'Mahony D. Prevention of potentially inappropriate prescribing for elderly patients: a randomized controlled trial using STOPP/START criteria. Clinical Pharmacology and Therapeutics 2011;89(6):845-54. [PUBMED: 21508941]
6. Gillespie U, Alassaad A, Henrohn D, Garmo H, Hammarlund-Udenaes M, Toss H, et al. A comprehensive pharmacist intervention to reduce morbidity in patients 80 years or older: a randomized controlled trial. Archives of Internal Medicine 2009;169(9):894-900. [PUBMED: 19433702]
7. Lisby M, Thomsen A, Nielsen LP, Lyhne NM, Breum-Leer C, Fredberg U, et al. The effect of systematic medication review in elderly patients admitted to an acute ward of internal medicine. Basic and Clinical Pharmacology and Toxicology 2010;106(5):422-7. [PUBMED: 20059474]
8. Lisby M, Bonnerup DK, Brock B, Gregersen PA, Jensen J, Larsen ML, et al. Medication review and patient outcomes in an orthopedic department: a randomized controlled study. Journal of Patient Safety 2015;March 4:[Epub ahead of print]. [PUBMED: 25742062]
9. Schnipper JL, Kirwin JL, Cotugno MC, Wahlstrom SA, Brown BA, Tarvin E, et al. Role of pharmacist counselling in preventing adverse drug events after hospitalization. Archives of Internal Medicine 2006;166(5):565-71. [PUBMED: 16534045]
10. Scullin C, Scott MG, Hogg A, McElnay JC. An innovative approach to integrated medicines management. Journal of Evaluation in Clinical Practice 2007;13(5):781-8. [PUBMED: 17824872]
11. [no author]. Hospital pharmacists and the NSF for CHD. Pharmaceutical Journal 2001;267(7169):518.
12. Ahmad A, Nijpels G, Dekker JM, Kostense PJ, Hugtenburg JG. Effect of a pharmacist medication review in elderly patients discharged from the hospital. Archives of Internal Medicine 2012;172(17):1346-7. [PUBMED: 22868274]
13. Allen CM, Becker PM, McVey LJ, Saltz C, Feussner JR, Cohen HJ. A randomized, controlled clinical trial of a geriatric consultation team. Compliance with recommendations. JAMA 1986;255(19):2617-21. [PUBMED: 3517396]
14. Al Mazroui NR, Kamal MM, Ghabash NM, Yacout TA, Kole PL, McElnay JC. Influence of pharmaceutical care on health outcomes in patients with Type 2 diabetes mellitus. British Journal of Clinical Pharmacology 2009;67(5):547-57. [PUBMED: 19552750]
15. Al-Rashed SA, Wright DJ, Roebuck N, Sunter W, Chrystyn H. The value of inpatient pharmaceutical counselling to elderly patients prior to discharge. British Journal of Clinical Pharmacology 2002;54(6):657-64. [PUBMED: 12492615]
16. Bolas H, Brookes K, Scott M, McElnay J. Evaluation of a hospital-based community liaison pharmacy service in Northern Ireland. Pharmacy World and Science 2004;26(2):114-20. [PUBMED: 15085948]
17. Bondesson A, Eriksson T, Kragh A, Holmdahl L, Midlov P, Hoglund P. In-hospital medication reviews reduce unidentified drug-related problems. European Journal of Clinical Pharmacology 2013;69(3):647-55. [PUBMED: 22955893]
18. Bonnet-Zamponi D, d'Arailh L, Konrat C, Delpierre S, Lieberherr D, Lemaire A, et al. Drug-related readmissions to medical units of older adults discharged from acute geriatric units: results of the Optimization of Medication in AGEd multicenter randomized controlled trial. Journal of the American Geriatrics Society 2013;61(1):113-21. [PUBMED: 23252914]
19. Burleson BS. Impact of pharmacist-conducted medication histories on number of pharmacist's interventions, drug cost, medication errors, re-admission rates, and mortality during hospitalization of medicine patients. ASHP Midyear Clinical Meeting. 2003; Vol. 38:P-610.
20. Burnett KM, Scott MG, Fleming GF, Clark CM, McElnay JC. Effects of an integrated medicines management program on medication appropriateness in hospitalized patients. American Journal of Health-System Pharmacy 2009;66(9):854-9.
21. Cardinale V. Clinical R.Ph.s in a team prove to be cost-effective. Drug Topics 1993;Jan Suppl:1.
22. Ciechanover M, Kohn D. A drug-reduction trial in elderly patients. Harefuah 1987;112(11):543-5.
23. Connor MO, O'Sullivan D, Gallagher P, Byrne S, Eustace J, O'Mahony D. Prevention of adverse drug events in hospitalised older patients: a randomised controlled trial. Irish Journal of Medical Science. Cork, Ireland: Conference: 60th Annual Scientific Meeting of the Irish Gerontological Society, 2012:S181-S223.
24. Crotty M, Rowett D, Spurling L, Giles LC, Phillips PA. Does the addition of a pharmacist transition coordinator improve evidence-based medication management and health outcomes in older adults moving from the hospital to a long-term care facility? Results of a randomized, controlled trial. American Journal of Geriatric Pharmacotherapy 2004;2(4):257-64. [PUBMED: 15903284]
25. Frankenthal D, Lerman Y, Kalendaryev E, Lerman Y. Intervention with the screening tool of older persons potentially inappropriate prescriptions/screening tool to alert doctors to right treatment criteria in elderly residents of a chronic geriatric facility: a randomized clinical trial. Journal of the American Geriatrics Society 2014;62(9):1658-65. [PUBMED: 25243680]
26. Gattis WA, Hasselblad V, Whellan DJ, O'Connor CM. Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team: results of the Pharmacist in Heart Failure Assessment Recommendation and Monitoring (PHARM) Study. Archives of Internal Medicine 1999;159(16):1939-45. [PUBMED: 10493325]
27. Hellstrom LM, Bondesson A, Hoglund P, Midlov P, Holmdahl L, Rickhag E, et al. Impact of the Lund Integrated Medicines Management (LIMM) model on medication appropriateness and drug-related hospital revisits. European Journal of Clinical Pharmacology 2011;67(7):741-52. [PUBMED: 21318595]
28. Kelly DM, Frick EM, Hale LS. How the medication review can help to reduce risk of falls in older patients. JAAPA 2011;24(4):30-4, 55. [PUBMED: 21534380]
29. Koehler BE, Richter KM, Youngblood L, Cohen BA, Prengler ID, Cheng D, et al. Reduction of 30-day postdischarge hospital readmission or emergency department (ED) visit rates in high-risk elderly medical patients through delivery of a targeted care bundle. Journal of Hospital Medicine 2009;4(4):211-8. [PUBMED: 19388074]
30. Lipton HL, Bero LA, Bird JA, McPhee SJ. The impact of clinical pharmacists' consultations on physicians' geriatric drug prescribing. A randomized controlled trial. Medical Care 1992;30(7):646-58. [PUBMED: 1614233]
31. Marusic S, Gojo-Tomic N, Erdeljic V, Bacic-Vrca V, Franic M, Kirin M, et al. The effect of pharmacotherapeutic counselling on readmissions and emergency department visits. International Journal of Clinical Pharmacy 2013;35(1):37-44. [PUBMED: 23007693]
32. McMullin ST, Hennenfent JA, Ritchie DJ, Huey WY, Lonergan TP, Schaiff RA, et al. A prospective, randomized trial to assess the cost impact of pharmacist-initiated interventions. Archives of Internal Medicine 1999;159(19):2306-9. [PUBMED: 10547170]
33. Naughton BJ, Moran MB, Feinglass J, Falconer J, Williams ME. Reducing hospital costs for the geriatric patient admitted from the emergency department: a randomized trial. Journal of the American Geriatrics Society 1994;42(10):1045-9. [PUBMED: 7930327]
34. NCT01467128 . Adverse Drug Event (ADE) Incidence in Older Patients Following Hospital Admission and Pharmacist Review to Older Persons' Prescriptions and Its' Effect on ADE Reduction in Hospital: A Randomised Controlled Trial. www.clinicaltrials.gov/show/NCT01467128 (accessed May 2015).
35. Pope G, Wall N, Peters CM, O'Connor M, Saunders J, O'Sullivan C, et al. Specialist medication review does not benefit short-term outcomes and net costs in continuing-care patients. Age and Ageing 2011;40(3):307-12. [PUBMED: 20817937]
36. Rainville EC. Impact of pharmacist interventions on hospital readmissions for heart failure. American Journal of Health-System Pharmacy 1999;56(13):1339-42. [PUBMED: 10683133]
37. Saltvedt I, Spigset O, Ruths S, Fayers P, Kaasa S, Sletvold O. Patterns of drug prescription in a geriatric evaluation and management unit as compared with the general medical wards: a randomised study. European Journal of Clinical Pharmacology 2005;61(12):921-8. [PUBMED: 16307267]
38. Schmader KE, Hanlon JT, Landsman PB, Samsa GP, Lewis IK, Weinberger M. Inappropriate prescribing and health outcomes in elderly veteran outpatients. The Annals of Pharmacotherapy 1997;31(5):529-33. [PUBMED: 9161643]
39. Schmader KE, Hanlon JT, Pieper CF, Sloane R, Ruby CM, Twersky J, et al. Effects of geriatric evaluation and management on adverse drug reactions and suboptimal prescribing in the frail elderly. American Journal of Medicine 2004;116(6):394-401. [PUBMED: 15006588]
40. Sjoberg C, Wallerstedt SM. Effects of medication reviews performed by a physician on treatment with fracture-preventing and fall-risk-increasing drugs in older adults with hip fracture - a randomized controlled study. Journal of the American Geriatrics Society 2013;61(9):1464-72. [PUBMED: 24028354]
41. Smith DM, Cox MR, Brizendine EJ, Hui SL, Freedman JA, Martin DK, et al. An intervention on discharge polypharmacy. Journal of the American Geriatrics Society 1996;44(4):416-9. [PUBMED: 8636588]
42. Spinewine A, Swine C, Dhillon S, Lambert P, Nachega JB, Wilmotte L, et al. Effect of a collaborative approach on the quality of prescribing for geriatric inpatients: a randomized, controlled trial. Journal of the American Geriatrics Society 2007;55(5):658-65. [PUBMED: 17493184]
43. Stowasser DA, Collins DM, Stowasser M. A randomised controlled trial of medication liaison services - patient outcomes. Journal of Pharmacy Practice and Research 2002;32:133-40.
44. Walker PC, Bernstein SJ, Tucker Jones JN, Piersma J, Kim HW, Regal RE, et al. Impact of a pharmacist-facilitated hospital discharge program: a quasi-experimental study. Archives of Internal Medicine 2009;169(21):2003-10. [PUBMED: 19933963]
45. ISRCTN08043800 . Pharmaceutical Optimization of the Medication Process During Admission to Hospital: A Multicentre, Randomised, Controlled Trial. www.isrctn.com/ISRCTN42003273 (accessed May 2015).
46. Loffler C, Drewelow E, Paschka SD, Frankenstein M, Eger J, Jatsch L, et al. Optimizing Polypharmacy Among Elderly Hospital Patients With Chronic Diseases - Study Protocol of the Cluster Randomized Controlled POLITE-RCT Trial. Implementation Science 2014;9:151. [PUBMED: 25287853]
47. NCT00844025 . Pharmaceutical Care and Clinical Outcomes for the Elderly Taking Potentially Inappropriate Medication. www.clinicaltrials.gov/show/NCT00844025 (accessed May 2015).
48. NCT01504672 . A Randomized Controlled Pharmacist Intervention Study to Reduce Drug-related Problems and Readmissions Among Old People With Dementia. www.clinicaltrials.gov/show/NCT01504672 (accessed May 2015).
49. Aronson JK. Polypharmacy, appropriate and inappropriate. The British Journal of General Practice 2006; Vol. 56, issue 528:484-5. [PUBMED: 16834872]
50. Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine. Archives of Internal Medicine 1991;151(9):1825-32. [PUBMED: 1888249]
51. Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly. An update. Archives of Internal Medicine 1997;157(14):1531-6. [PUBMED: 9236554]
52. Bourgeois FT, Shannon MW, Valim C, Mandl KD. Adverse drug events in the outpatient setting: an 11-year national analysis. Pharmacoepidemiology and Drug Safety 2010;19(9):901-10. [PUBMED: 20623513]
53. Bregnhøj L, Thirstrup S, Kristensen MB, Bjerrum L, Sonne J. Combined intervention programme reduces inappropriate prescribing in elderly patients exposed to polypharmacy in primary care. European Journal of Clinical Pharmacology 2009;65(2):199-207. [PUBMED: 18807252]
54. Budnitz DS, Lovegrove MC, Shehab N, Richards CL. Emergency hospitalizations for adverse drug events in older Americans. The New England Journal of Medicine 2011;365(21):2002-12. [PUBMED: 22111719]
55. Centers for Disease Control and Prevention. Health, United States, 2011. Atlanta: Centers for Disease Control and Prevention, 2012.
56. Chen TF, de Almeida Neto AC. Exploring elements of interprofessional collaboration between pharmacists and physicians in medication review. Pharmacy World and Science 2007;29(6):574-6. [PUBMED: 17479354]
57. Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet 2009;374(9696):1196-208. [PUBMED: 19801098]
58. Classen DC, Pestotnik SL, Evans RS, Lloyd JF, Burke JP. Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality. JAMA 1997;277(4):301-6. [PUBMED: 9002492]
59. Deeks JJ, Higgins JPT, Altman DG (editors). Chapter 9: Analysing data and undertaking meta-analyses. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. www.cochrane-handbook.org.
60. Ebbesen J, Buajordet I, Erikssen J, Brors O, Hilberg T, Svaar H, et al. Drug-related deaths in a department of internal medicine. Archives of Internal Medicine 2001;161(19):2317-23. [PUBMED: 11606147]
61. ElDesoky ES. Pharmacokinetic-pharmacodynamic crisis in the elderly. American Journal of Therapeutics 2007;14(5):488-98. [PUBMED: 17890940]
62. EPOC . Suggested risk of bias criteria for EPOC reviews: suggested risk of bias criteria for EPOC reviews. http://epoc.cochrane.org/sites/epoc.cochrane.org/files/uploads/ (accessed November 2015).
63. Epstein AM, Jha AK, Orav EJ. The relationship between hospital admission rates and rehospitalizations. The New England Journal of Medicine 2011;365(24):2287-95. [PUBMED: 22168643]
64. European Communities. Population statistics 2006. www.epp.eurostat.ec.europa.eu/cache/ITY_OFFPUB/KS-EH-06-001/EN/KS-EH-06-001-EN.PDF (accessed 1 April 2012).
65. Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Archives of Internal Medicine 2003;163(22):2716-24. [PUBMED: 14662625]
66. Gallagher P, Ryan C, Byrne S, Kennedy J, O'Mahony D. STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. International Journal of Clinical Pharmacology and Therapeutics 2008;46(2):72-83. [PUBMED: 18218287]
67. Gallagher P, O'Mahony D. STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers' criteria. Age and Ageing 2008;37(6):673-9. [PUBMED: 18829684]
68. Gnjidic D, Hilmer SN, Blyth FM, Naganathan V, Waite L, Seibel MJ, et al. Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. Journal of Clinical Epidemiology 2012;65(9):989-95. [PUBMED: 22742913]
69. Gutierrez J, Ramirez G, Rundek T, Sacco RL. Statin therapy in the prevention of recurrent cardiovascular events: a sex-based meta-analysis. Archives of Internal Medicine 2012;172(12):909-19. [PUBMED: 22732744]
70. Guyatt GH, Oxman AD, Vist G, Kunz R, Falck-Ytter Y, Alonso-Coello P, Schünemann HJ, for the GRADE Working Group. Rating quality of evidence and strength of recommendations GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924-6.
71. Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. The American Journal of Geriatric Pharmacotherapy 2007;5(4):345-51. [PUBMED: 18179993]
72. Hallas J. Drug related hospital admissions in subspecialities of internal medicine. Danish Medical Bulletin 1996;43(2):141-55. [PUBMED: 8741207]
73. Hanlon JT, Schmader KE, Samsa GP, Weinberger M, Uttech KM, Lewis IK, et al. A method for assessing drug therapy appropriateness. Journal of Clinical Epidemiology 1992;45(10):1045-51. [PUBMED: 1474400]
74. Hanlon JT, Artz MB, Pieper CF, Lindblad CI, Sloane RJ, Ruby CM, et al. Inappropriate medication use among frail elderly inpatients. The Annals of Pharmacotherapy 2004;38(1):9-14. [PUBMED: 14742785]
75. Hasan O, Meltzer DO, Shaykevich SA, Bell CM, Kaboli PJ, Auerbach AD, et al. Hospital readmission in general medicine patients: a prediction model. Journal of General Internal Medicine 2010;25(3):211-9. [PUBMED: 20013068]
76. Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. www.cochrane-handbook.org.
77. Hohl CM, Wickham ME, Sobolev B, Perry JJ, Sivilotti ML, Garrison S, et al. The effect of early in-hospital medication review on health outcomes: a systematic review. British Journal of Clinical Pharmacology 2015;80(1):51-61. [PUBMED: 25581134]
78. Holland R, Desborough J, Goodyer L, Hall S, Wright D, Loke YK. Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. British Journal of Clinical Pharmacology 2008;65(3):303-16. [PUBMED: 18093253]
79. Holt S, Schmiedl S, Thurmann PA. Potentially inappropriate medications in the elderly: the PRISCUS list. Deutsches Arzteblatt international 2010;107(31-32):543-51. [PUBMED: 20827352]
80. Hughes CM. Medication non-adherence in the elderly: how big is the problem?. Drugs & Aging 2004;21(12):793-811. [PUBMED: 15382959]
81. Joint Commission. Comprehensive Accreditation Manual for Hospitals (CAMH): The Official Handbook. www.jcrinc.com/Joint-Commission-Requirements/ (accessed 19 December 2011).
82. Jones D, Seymour R, Woodhouse K. Use of pharmacists by older people in the community. Archives of Gerontology and Geriatrics 1997;24(1):9-13. [PUBMED: 15374131]
83. Kongkaew C, Noyce PR, Ashcroft DM. Hospital admissions associated with adverse drug reactions: a systematic review of prospective observational studies. The Annals of Pharmacotherapy 2008;42(7):1017-25. [PUBMED: 18594048]
84. Laroche ML, Charmes JP, Merle L. Potentially inappropriate medications in the elderly: a French consensus panel list. European Journal of Clinical Pharmacology 2007;63(8):725-31. [PUBMED: 17554532]
85. Laroche ML, Charmes JP, Nouaille Y, Picard N, Merle L. Is inappropriate medication use a major cause of adverse drug reactions in the elderly?. British Journal of Clinical Pharmacology 2007;63(2):177-86. [PUBMED: 17166186]
86. Lefebvre C, Manheimer E, Glanville J. Chapter 6: Searching for studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. www.cochrane-handbook.org.
87. Lozano-Montoya I, Velez-Diaz-Pallares M, Delgado-Silveira E, Montero-Errasquin B, Cruz Jentoft AJ. Potentially inappropriate prescribing detected by STOPP-START criteria: are they really inappropriate?. Age and Ageing 2015;44(5):861-6. [PUBMED: 26175348]
88. Lund BC, Carnahan RM, Egge JA, Chrischilles EA, Kaboli PJ. Inappropriate prescribing predicts adverse drug events in older adults. The Annals of Pharmacotherapy 2010;44(6):957-63. [PUBMED: 20460558]
89. Mangoni AA, Jackson SH. Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. British Journal of Clinical Pharmacology 2004;57(1):6-14. [PUBMED: 14678335]
90. Mannheimer B, Ulfvarson J, Eklof S, Bergqvist M, Andersen-Karlsson E, Pettersson H, et al. Drug-related problems and pharmacotherapeutic advisory intervention at a medicine clinic. European Journal of Clinical Pharmacology 2006;62(12):1075-81. [PUBMED: 17066294]
91. Marcantonio ER, McKean S, Goldfinger M, Kleefield S, Yurkofsky M, Brennan TA. Factors associated with unplanned hospital readmission among patients 65 years of age and older in a Medicare managed care plan. The American Journal of Medicine 1999;107(1):13-7. [PUBMED: 10403347]
92. McLeod PJ, Huang AR, Tamblyn RM, Gayton DC. Defining inappropriate practices in prescribing for elderly people: a national consensus panel. CMAJ 1997;156(3):385-91. [PUBMED: 9033421]
93. Naugler CT, Brymer C, Stolee P, Arcese ZA. Development and validation of an improving prescribing in the elderly tool. The Canadian Journal of Clinical Pharmacology 2000;7(2):103-7. [PUBMED: 10958706]
94. Nkansah N, Mostovetsky O, Yu C, Chheng T, Beney J, Bond CM, et al. Effect of outpatient pharmacists' non-dispensing roles on patient outcomes and prescribing patterns. Cochrane Database of Systematic Reviews 2010, Issue 7. [DOI: 10.1002/14651858.CD000336.pub2]
95. O'Mahony D, O'Sullivan D, Byrne S, O'Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age and Ageing 2015;44(2):213-8. [PUBMED: 25324330]
96. Obreli-Neto PR, Nobili A, de Oliveira Baldoni A, Guidoni CM, de Lyra Junior DP, Pilger D, et al. Adverse drug reactions caused by drug-drug interactions in elderly outpatients: a prospective cohort study. European Journal of Clinical Pharmacology 2012;68(12):1667-76. [PUBMED: 22644345]
97. Page RL 2nd, Linnebur SA, Bryant LL, Ruscin JM. Inappropriate prescribing in the hospitalized elderly patient: defining the problem, evaluation tools, and possible solutions. Clinical Interventions in Aging 2010;5:75-87. [PUBMED: 20396637]
98. Pasina L, Brucato AL, Falcone C, Cucchi E, Bresciani A, Sottocorno M, et al. Medication non-adherence among elderly patients newly discharged and receiving polypharmacy. Drugs & Aging 2014;31(4):283-9. [PUBMED: 24604085]
99. Patterson SM, Hughes C, Kerse N, Cardwell CR, Bradley MC. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database of Systematic Reviews 2012, Issue 5. [DOI: 10.1002/14651858.CD008165.pub2; PUBMED: 22592727]
100. Pefoyo AJ, Bronskill SE, Gruneir A, Calzavara A, Thavorn K, Petrosyan Y, et al. The increasing burden and complexity of multimorbidity. BMC Public Health 2015;15:415. [PUBMED: 25903064]
101. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2012.
102. Rogers G, Alper E, Brunelle D, Federico F, Fenn CA, Leape LL, et al. Reconciling medications at admission: safe practice recommendations and implementation strategies. Joint Commission Journal on Quality and Patient Safety/Joint Commission Resources 2006;32(1):37-50. [PUBMED: 16514938]
103. Rothschild JM, Bates DW, Leape LL. Preventable medical injuries in older patients. Archives of Internal Medicine 2000;160(18):2717-28. [PUBMED: 11025781]
104. Routledge PA, O'Mahony MS, Woodhouse KW. Adverse drug reactions in elderly patients. British Journal of Clinical Pharmacology 2004;57(2):121-6. [PUBMED: 14748810]
105. Royal S, Smeaton L, Avery AJ, Hurwitz B, Sheikh A. Interventions in primary care to reduce medication related adverse events and hospital admissions: systematic review and meta-analysis. Quality and Safety in Health Care 2006;15(1):23-31. [PUBMED: 16456206]
106. Ryan C, O'Mahony D, Kennedy J, Weedle P, Byrne S. Potentially inappropriate prescribing in an Irish elderly population in primary care. British Journal of Clinical Pharmacology 2009;68(6):936-47. [PUBMED: 20002089]
107. Salter C, Holland R, Harvey I, Henwood K. "I haven't even phoned my doctor yet." The advice giving role of the pharmacist during consultations for medication review with patients aged 80 or more: qualitative discourse analysis. BMJ 2007;334(7603):1101. [PUBMED: 17449504]
108. Samsa GP, Hanlon JT, Schmader KE, Weinberger M, Clipp EC, Uttech KM, et al. A summated score for the medication appropriateness index: development and assessment of clinimetric properties including content validity. Journal of Clinical Epidemiology 1994;47(8):891-6. [PUBMED: 7730892]
109. Schneeweiss S, Hasford J, Gottler M, Hoffmann A, Riethling AK, Avorn J. Admissions caused by adverse drug events to internal medicine and emergency departments in hospitals: a longitudinal population-based study. European Journal of Clinical Pharmacology 2002;58(4):285-91. [PUBMED: 12136375]
110. Spinewine A, Schmader KE, Barber N, Hughes C, Lapane KL, Swine C, et al. Appropriate prescribing in elderly people: how well can it be measured and optimised?. Lancet 2007;370(9582):173-84. [PUBMED: 17630041]
111. Steurbaut S, Leemans L, Leysen T, De Baere E, Cornu P, Mets T, et al. Medication history reconciliation by clinical pharmacists in elderly inpatients admitted from home or a nursing home. The Annals of Pharmacotherapy 2010;44(10):1596-603. [PUBMED: 20736427]
112. Wallerstedt SM, Kindblom JM, Nylen K, Samuelsson O, Strandell A. Medication reviews for nursing home residents to reduce mortality and hospitalization: systematic review and meta-analysis. British Journal of Clinical Pharmacology 2014;78(3):488-97. [PUBMED: 24548138]
113. Wright JM, Musini VM. First-line drugs for hypertension. Cochrane Database of Systematic Reviews 2009, Issue 3. [DOI: 10.1002/14651858.CD001841.pub2; PUBMED: 19588327]
114. Zed PJ, Abu-Laban RB, Balen RM, Loewen PS, Hohl CM, Brubacher JR, et al. Incidence, severity and preventability of medication-related visits to the emergency department: a prospective study. Canadian Medical Association Journal 2008;178(12):1563-9. [PUBMED: 18519904]
115. Zermansky AG, Petty DR, Raynor DK, Freemantle N, Vail A, Lowe CJ. Randomised controlled trial of clinical medication review by a pharmacist of elderly patients receiving repeat prescriptions in general practice. BMJ (Clinical research ed.) 2001;323(7325):1340-3. [PUBMED: 11739221]
116. Ziere G, Dieleman JP, Hofman A, Pols HA, van der Cammen TJ, Stricker BH. Polypharmacy and falls in the middle age and elderly population. British Journal of Clinical Pharmacology 2006;61(2):218-23. [PUBMED: 16433876]
117. Zulman DM, Sussman JB, Chen X, Cigolle CT, Blaum CS, Hayward RA. Examining the evidence: a systematic review of the inclusion and analysis of older adults in randomized controlled trials. Journal of General Internal Medicine 2011;26(7):783-90. [PUBMED: 21286840]
118. Christensen M, Lundh A. Medication review of hospitalized patients to prevent morbidity and mortality. Cochrane Database of Systematic Reviews 2011, Issue 2. [DOI: 10.1002/14651858.CD008986]
119. Christensen M, Lundh A. Medication review in hospitalised patients to reduce morbidity and mortality. The Cochrane Database of Systematic Reviews 2013;2:CD008986. [PUBMED: 23450593]