Medication review interventions to reduce hospital readmissions in older people.
Medication review interventions to reduce hospital readmissions in older people.
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DOI：
10.1111/jgs.17041
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发表时间：
2021-06
影响因子：
6.3
通讯作者：
Knol W
中科院分区：
文献类型：
--
作者：
Dautzenberg L;Bretagne L;Koek HL;Tsokani S;Zevgiti S;Rodondi N;Scholten RJPM;Rutjes AW;Di Nisio M;Raijmann RCMA;Emmelot-Vonk M;Jennings ELM;Dalleur O;Mavridis D;Knol W
评估药物审查作为一种单独干预措施和几种联合干预措施预防老年人再次入院的有效性。检索了奥维德MEDLINE、Embase、科克伦对照试验中心和CINAHL中评价药物审查干预（有或无联合干预）预防≥65岁住院或近期出院成人再次住院的有效性的随机对照试验，直至2019年9月13日。包括的结局是“30天内以及指标入院出院后的任何时间至少一次全因再入院”。25项研究符合入选标准。其中，11项研究（7，318名受试者）对30天内全因再入院的网络Meta分析（NMA）做出了贡献。药物审查结合（a）药物核对和患者教育（风险比（RR）0.45; 95%置信区间（CI）0.26-0.80）和（B）药物协调、患者教育、专业教育和过渡期护理（RR 0.64; 95% CI 0.49-0.84）与常规治疗相比，全因再入院的风险较低相关。单独的药物审查对再入院没有显著影响（RR 1.06; 95% CI 0.45-2.51）。关于任何时间全因再入院的NMA包括24项研究（11，677例受试者）。与常规护理相比，药物审查结合药物核对、患者教育、专业教育和过渡性护理导致再入院率降低（RR 0.82; 95% CI 0.74-0.91）。本系统性综述中纳入的研究质量引起了一些担忧，主要涉及分配隐藏、设盲和污染。与常规护理相比，药物审查与药物核对、患者教育、专业教育和过渡护理相结合，与更低的再入院风险相关。未证实无联合干预的药物审查的影响。这一领域需要更高质量的试验。
To assess the efficacy of medication review as an isolated intervention and with several co‐interventions for preventing hospital readmissions in older adults. Ovid MEDLINE, Embase, The Cochrane Central Register of Controlled Trials and CINAHL were searched for randomized controlled trials evaluating the effectiveness of medication review interventions with or without co‐interventions to prevent hospital readmissions in hospitalized or recently discharged adults aged ≥65, until September 13, 2019. Included outcomes were “at least one all‐cause hospital readmission within 30 days and at any time after discharge from the index admission.” Twenty‐five studies met the inclusion criteria. Of these, 11 studies (7,318 participants) contributed to the network meta‐analysis (NMA) on all‐cause hospital readmission within 30 days. Medication review in combination with (a) medication reconciliation and patient education (risk ratio (RR) 0.45; 95% confidence interval (CI) 0.26–0.80) and (b) medication reconciliation, patient education, professional education and transitional care (RR 0.64; 95% CI 0.49–0.84) were associated with a lower risk of all‐cause hospital readmission compared to usual care. Medication review in isolation did not significantly influence hospital readmissions (RR 1.06; 95% CI 0.45–2.51). The NMA on all‐cause hospital readmission at any time included 24 studies (11,677 participants). Medication review combined with medication reconciliation, patient education, professional education and transitional care resulted in a reduction of hospital readmissions (RR 0.82; 95% CI 0.74–0.91) compared to usual care. The quality of the studies included in this systematic review raised some concerns, mainly regarding allocation concealment, blinding and contamination. Medication review in combination with medication reconciliation, patient education, professional education and transitional care, was associated with a lower risk of hospital readmissions compared to usual care. An effect of medication review without co‐interventions was not demonstrated. Trials of higher quality are needed in this field.
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影响因子：
2.4
作者：
Edey, Rachel;Edwards, Nicholas;Martinusen, Dan
通讯作者：
Martinusen, Dan
影响因子：
3.7
作者：
Elliott LS;Henderson JC;Neradilek MB;Moyer NA;Ashcraft KC;Thirumaran RK
通讯作者：
Thirumaran RK
影响因子：
3.7
作者：
Hohl CM;Partovi N;Ghement I;Wickham ME;McGrail K;Reddekopp LN;Sobolev B
通讯作者：
Sobolev B
影响因子：
2.9
作者：
Huiskes VJ;Burger DM;van den Ende CH;van den Bemt BJ
通讯作者：
van den Bemt BJ
影响因子：
7.2
作者：
HANLON, JT;SCHMADER, KE;FEUSSNER, JR
通讯作者：
FEUSSNER, JR