Crotty 2004b.

Methods	RCT (randomised by patient) Total study duration: 8 weeks
Participants	110 patients (56 intervention, 54 control) from three hospitals discharged to 85 long‐term facilities Setting: Long‐term care facilities Age: Mean 82.7, .SD 6.4 Gender: 67 women (60.9%), 43 men (39.1%) Country: Australia Date of study: October 2002 to July 2003
Interventions	Pharmacist transition co‐ordinator The intervention focused on transferring information on medications to care providers in the long‐term care facilities, including the nursing staff, the family physician and the accredited community pharmacist.  On the patient’s discharge from the hospital to the long‐term care facility both the family physician and the community pharmacist were faxed a medication transfer summary compiled by the transition pharmacist and signed by the hospital medical officer.  This communication supplemented the usual hospital discharge summary and included specific information on changes to medications that had been made in the hospital and aspects of medication management that required monitoring. After transfer of the patient to the long‐term care facility, the transition pharmacist co‐ordinated an evidence‐based medication review that was to be performed by the community pharmacist contracted to the facility within 10 to 14 days of the transfer. The transition pharmacist also co‐ordinated a case conference involving him or herself, the family physician, the community pharmacist and a registered nurse at the facility within 14 to 28 days of the transfer.  At this case conference, the transition pharmacist provided information concerning medication use and appropriateness The usual hospital discharge process received by the control group included a standard hospital discharge summary
Outcomes	Measured at baseline and eight weeks post‐discharge: Adverse drug events (not defined) Hospital admissions (emergency department visits and hospital readmissions) Medication‐related problems Medication appropriateness (MAI) Not used for this review: Falls Worsening mobility Worsening behaviours Increased confusion Worsening pain
Notes	Funded by the Australian Commonwealth Department Of Health and Ageing National Demonstration Hospitals Program.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Study biostatistician provided a computer‐generated allocation sequence using block randomisation
Allocation concealment (selection bias)	Low risk	Randomisation was co‐ordinated by a centralised hospital pharmacy service
Blinding of participants and personnel (performance bias) All outcomes	High risk	No blinding conducted
Blinding of outcome assessment (detection bias) Subjective outcomes	Low risk	Independent pharmacists blinded to allocation assessed Medication Appropriateness Index (MAI)
Blinding of outcome assessment (detection bias) Objective outcomes	Low risk	No blinding conducted, however outcomes not likely to be influenced by lack of blinding
Incomplete outcome data (attrition bias) Primary outcomes	Low risk	Similar attrition in both groups with similar reasons for dropouts. Described as intention‐to‐treat by authors
Incomplete outcome data (attrition bias) Secondary outcomes	Low risk	Similar attrition in both groups with similar reasons for dropouts. Described as intention‐to‐treat by authors
Selective reporting (reporting bias)	Unclear risk	Insufficient information to permit judgement
Similar baseline outcome measurements	Low risk	Similar Medication Appropriateness Index scores at baseline. Other outcomes not measured at baseline
Similar baseline characteristics	Low risk	Similar baseline characteristics reported except more pre‐admission medications discontinued during hospitalisation in the control group
Reliable primary outcome measure	Low risk	Medication Appropriateness Index
Adequate protection against contamination	High risk	Randomised by patient therefore contamination possible
Other bias	Low risk	Appears to be free of other sources of bias