Table 1.
Randomized Controlled Trials Evaluating Interventions to Reduce Adverse Drug Reactions in Older Adults
| Author, Year |
Country | Setting | Sample Size, N |
ADR Method | Follow-Up Time | |
|---|---|---|---|---|---|---|
| Detection | ADR Causality Assessment | |||||
| Pharmacist-Led Interventions | ||||||
| Crotty, 2004 | Australia | Hospital to long-term care facility | 110 | Chart review | Causality assessment method and number and type of reviewers not reported | 8 weeks |
| Gillespie, 2009 | Sweden | Hospital and homea | 400 | Chart review | DRP definition for ADR; 2 pharm reviewersv | 12 months |
| Hanlon, 1996 | US | Veterans Affairs clinic | 208 | Patient survey | Known effect as per two pharmacology texts; 1 pharm reviewer | 12 months |
| Kwint, 2011 | Netherlands | Community pharmacies | 125 | Chart review | DRP definition for ADR; Consensus of 2 pharm reviewers | 6 months |
| Lenander, 2014 | Sweden | Primary care center | 209 | Patient interview | DRP definition for ADR; 1 pharm reviewer | 12 months |
| Touchette, 2012 | US | Outpatient clinics | 637 | Patient interview | Naranjo algorithm; 1 pharm reviewer | 6 months |
| Willoch, 2012 | Norway | Hospital rehabilitation ward | 77 | Chart review, patient questionnaire | DRP definition for ADR; number and type of reviewers not reported | 3 months |
| O’Sullivan, 2016 | Ireland | Hospital | 737 | Chart review using trigger tool | WHO Uppsala Monitoring Centre algorithm; 2 pharm reviewersb | 7–10 days post-admission or discharge |
| Other Health Professional-Led Interventions | ||||||
| Field, 2011 | US | Nursing homes | 435 | Chart and lab review | IOM definition for ADR; Consensus of pairs of 3 MD reviewers for warfarin bleed | 1 year |
| O’Connor, 2016 | Ireland | Hospital | 732 | Chart review using trigger tool | WHO Uppsala Monitoring Centre algorithm; 1 MD reviewer | 7 to 10 days post-admission or discharge |
| Schmader, 2004 | US | Veterans Affairs hospitals | 834 | Chart review using trigger tool | Naranjo algorithm; Consensus of pharm-MD pairs | 10–11 days |
| Schmader, 2004c | US | Veterans Affairs clinics | 808 | Chart review using trigger tool, patient interview | Naranjo algorithm; Consensus of pharm-MD pairs | 12 months |
| Brief Educational Session | ||||||
| Trivalle, 2010 | France | Hospital (rehabilitation centers) | 576 | Chart review using check-list | Causality assessment method not reported; 4 multidisciplinary (MD and pharm) reviewersb | 2 weeks |
| Technology Interventions | ||||||
| Gurwitz, 2008 | Canada and US | Long-term care facilities | 1,118 | Chart review | IOM definition for ADR; Consensus of pairs of 5 MD reviewers | 6 months for one site; 1 year for other site |
a
Intervention began in the hospital and spanned hospital discharge and 2 months follow-up;
b
Whether consensus was reached among multiple reviewers not stated.
c
Study was a 2×2 factorial design; following. ADR=Adverse drug reaction; DRP=drug related problem; IOM=Institute of Medicine; MD=physician; Pharm=pharmacists; WHO=World Health Organization