Zermansky 2006.

Study characteristics
Methods	An open randomised controlled trial of clinical medication review by a pharmacist of elderly care home residents against usual care Study duration: 6 months
Participants	661 participants (331 intervention group but only 315 received Intervention) and 330 participants in the control group Setting: aged care facilities in Leeds, UK (nursing, residential and mixed care homes for older people in Leeds, UK) Diagnostic criteria: residents aged ≥ 65, seeking to recruit all residents taking ≥ 1 repeat medicines Age (years) (mean ± SD): age mean (interquartile range), Intervention 85.3 (81 to 90) and control 84.9 (80 to 90) Sex male n (%): intervention 75 (22.7), control 79 (23.9) Country: UK Comorbidity: not stated Sociodemographics: not stated Ethnicity: not stated Date of study: not reported, but paper first published 12/8/2006
Interventions	1 intervention A clinical medication review was conducted by the study pharmacist within 28 days of randomisation. It comprised a review of the general practice clinical record and a consultation with the participant and carer. The pharmacist formulated recommendations with the participant and carer and passed them on a written proforma to the GP for acceptance and implementation. GP acceptance was signified by ticking a box on the proforma. Control participants received usual GP care
Outcomes	The primary outcome measure was the number of changes in medication per participant. Secondary outcome measures were the following: medication outcomes: number of repeat medicines per participant, cost of 28 days of repeat medicines per participant at end date, recorded medication reviews in the study period clinical outcomes in 6 months: falls, number of GP consultations, Barthel Index, Standardised Mini‐Mental State Examination, mortality, hospital admissions hospitalisation in 6 months per participant and number of deaths
Notes	Randomisation was curtailed on 30 June 2003 when it became clear that the intended sample size was not achievable within the available timescale. Data were analysed on an intention‐to‐treat basis.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Participants were randomly sized blocks.
Allocation concealment (selection bias)	Unclear risk	This is not mentioned in the study.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	It is not clear if the participants were blinded to the intervention.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Some participants did not complete the study and were reported in the study.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	A nurse blind to the study assessed participants.
Selective reporting (reporting bias)	Low risk	All outcomes were reported.
Protection against contamination bias	Unclear risk	It is difficult to determine if the intervention group was contaminated by the control group.
Other bias	Unclear risk	It is difficult to determine if there are other biases.

ADL: activities of daily living; BPMDL: best possible medication discharge list; CI: confidence interval; CHAP: Cardiovascular Health Awareness Program; CHD: coronary heart disease; CHF: congestive heart failure; COPD: chronic obstructive pulmonary disease; ED: emergency department; EuroQoL‐5D: EuroQol Group Association ("The EuroQol Group") comprises a network of international, multilingual, multidisciplinary researchers; EQ‐5D: a standardised instrument for use as a measure of health outcome; GP: general practitioner; ICU: intensive care unit; QoL: quality of life; RT: randomised trial; SD: standard deviation; SF‐12: Short Form‐12; SF‐36: Short Form‐36; STOPP: Screening Tool of Older Persons Prescriptions; START: Screening Tool to Alert Doctors to Right Treatment