Clinical medication review type III of polypharmacy reduced unplanned hospitalizations in older adults: A meta-analysis of randomized clinical trials

Fumihiro Mizokami, Tomohiro Mizuno, Koichiro Kanamori, Sakiko Oyama, Tadashi Nagamatsu, Jeannie K. Lee, Tomoharu Kobayashi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Aim: To analyze the impact of clinical medication reviews (CMR) on reducing unplanned hospitalizations owing to polypharmacy among older adults using an intervention. Methods: Our meta-analysis complied with PRISMA guidelines. The literature review comprised a search for articles published between January 1972 and March 2017 on MEDLINE and Google Scholar. We identified randomized controlled trials focusing on CMR that evaluated unplanned hospitalization and re-hospitalization among older adults as a primary outcome. The keywords used were “CMR” or “medication review” in their titles, and the phrases “elderly” or “older adults” or “geriatric” and “polypharmacy.” The randomized controlled trials selected were divided according to the three types of CMR to analyze the characteristics of each review. Results: We included nine randomized controlled trials that examined the impact of CMR of polypharmacy in older patients. Five trials corresponded to CMR type I (prescription only review) or II (adherence review), whereas four corresponded to type III (comprehensive clinical evaluation for disease management). Type I/II increased the number of unplanned hospitalizations (RR 1.22, 95% CI 1.07–1.38, P = 0.002), whereas type III decreased hospital admissions (RR 0.86, 95% CI 0.79–0.95, P = 0.001). Conclusions: The present findings show the need for an intervention standardization for CMR, particularly for type III in older adults with polypharmacy, to decrease hospitalizations. Geriatr Gerontol Int 2019; 19: 1275–1281.

Original languageEnglish (US)
Pages (from-to)1275-1281
Number of pages7
JournalGeriatrics and Gerontology International
Volume19
Issue number12
DOIs
StatePublished - Dec 1 2019

Keywords

  • clinical medication review
  • meta-analysis
  • older adults
  • polypharmacy
  • unplanned admission

ASJC Scopus subject areas

  • Health(social science)
  • Gerontology
  • Geriatrics and Gerontology

Fingerprint

Dive into the research topics of 'Clinical medication review type III of polypharmacy reduced unplanned hospitalizations in older adults: A meta-analysis of randomized clinical trials'. Together they form a unique fingerprint.

Cite this