Lapane 2011.

Study characteristics
Methods	Cluster‐RT Study duration: 2 years
Participants	6523 participants Final sample: 1769 control, 1769 intervention Diagnostic criteria: not relevant as homes were the unit of analysis not individuals Age (years) (mean ± SD): average age of residents was not reported. At baseline 16% of the residents in both intervention and control homes were aged 65‐74 years, 36% in intervention homes and 35% in usual care homes were 75‐84 years, and 40% of the residents in the intervention homes and 36% in the usual care homes were ≥ 85 years. During the intervention period, 15% in both groups were 65‐74 years, 39% were 75‐84 years, and 39% were ≥ 85 years Sex, female n (%): at baseline, 72% of the residents in the intervention homes and 68% in the usual‐care homes were female. During the intervention period, 74% of the residents in the intervention and usual‐care homes were female. Country: USA Comorbidity: (intervention, control), dementia (35.4, 43.4); Alzheimer's disease (12.7, 14.6), cancer (8.3, 12.1), diabetes mellitus (27.5, 31.0), cerebrovascular accident (22.2, 22.4), heart failure (26.5, 28.5), coronary artery disease (18.6, 16.2), arrhythmia (15.8, 15.8), hypertension (64.9, 61.8), other cardiovascular disease (23.6, 28.0) Sociodemographics: nothing reported other than race Ethnicity: 18% in intervention group and 11% in usual care group were minority race at baseline. During the intervention period, 19% of both groups were minority race Date of study: 2003‐2004
Interventions	Professional intervention The overarching idea was to use health information technology to engage consultant pharmacists and nursing staff to identify residents at risk for delirium and falls, implement proactive monitoring plans as appropriate, and provide reports to assist consultant pharmacists in conducting the medication regimen review. Intervention: A Geriatric Risk Assessment MedGuide database for falls and delirium was integrated into the pharmacies' commercial pharmacy software system (Rescot LTCP System) for the intervention homes. Control: usual care
Outcomes	Incidence of potential delirium, falls, hospitalisations potentially due to adverse drug events, and mortality
Notes	Residents in the intervention homes experienced fewer falls, less potential delirium, and death, but more hospitalisations than in the comparison homes. In new admissions, there appeared to be a trend toward lower mortality (adjusted hazard ratio 0.88, 95% CI 0.66 to 1.16) and a lower overall hospitalisation rate (adjusted hazard ratio 0.89, 95% CI 0.72 to 1.09) and a clear reduction in the rate of potential delirium (adjusted hazard ratio 0.42, 95% CI 0.35 to 0.52) in the intervention homes than the comparison homes.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not reported
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Cluster‐randomisation
Incomplete outcome data (attrition bias) All outcomes	Low risk	All participants were reported.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not stated
Selective reporting (reporting bias)	Low risk	All outcomes were reported.
Protection against contamination bias	Low risk	It can not be determined if the intervention group was contaminated with the control group.
Other bias	Unclear risk	There is no evidence of the presence of other bias. We considered other bias due to cluster randomisation.