Frankenthal 2014.
| Methods | RCT (randomised by patient) Total study duration: 1 year |
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| Participants | 359 residents (176 control, 183 intervention) Setting: Chronic care geriatric facility Age: Mean 82.7 Gender: Intervention male 29.5%, control male 37.5% Country: Israel Date of Study: Not Stated |
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| Interventions | The intervention consisted of a medication review by the study pharmacist for all residents at study opening and six and 12 months later. The STOPP/START criteria were applied to identify potentially inappropriate prescriptions (PIPs) and potential prescription omissions (PPOs). Interventional recommendations that the study pharmacist made for residents in the intervention group but not in the control group were discussed with the chief physician at study opening and after six months. The chief physician decided whether to accept these recommendations and implement prescribing changes | |
| Outcomes | Measured at baseline and at 12 months: Hospital admissions (not defined) Mortality Quality of life (Medical Outcomes Study 12‐item Short‐Form Health Survey [SF‐12]) Medication‐related problems (number of pharmacist recommendations, acceptance of recommendations by the physician, number of treatment changes) Medication appropriateness (STOPP‐START) Medication costs (Average monthly medication costs in Israeli Shekels) Not used for this review: Falls Functioning (Functional Indepence Measure) |
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| Notes | Study was supported partly by a research grant from Keshet Association for the Elderly in Tel‐Aviv‐Yaffo | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Insufficient information to permit judgement |
| Allocation concealment (selection bias) | Unclear risk | Insufficient information to permit judgement |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Blinding not conducted |
| Blinding of outcome assessment (detection bias) Subjective outcomes | High risk | Nurses who were unaware of group assignments assessed outcome measures. However, the study pharmacist collected data on outcome measures at follow‐up. |
| Blinding of outcome assessment (detection bias) Objective outcomes | Low risk | Nurses who were unaware of group assignments assessed outcome measures. However, the study pharmacist collected data on outcome measures at follow‐up. Outcomes not likely to be influenced by lack of blinding |
| Incomplete outcome data (attrition bias) Primary outcomes | Low risk | Reasons and proportions for attrition documented and similar in intervention and control. |
| Incomplete outcome data (attrition bias) Secondary outcomes | Low risk | Reasons and proportions for attrition documented and similar in intervention and control. |
| Selective reporting (reporting bias) | Unclear risk | Insufficient information to permit judgement |
| Similar baseline outcome measurements | Low risk | Similar baseline outcomes for falls, hospitalisations and medicine costs |
| Similar baseline characteristics | Low risk | Similar baseline characteristics reported |
| Reliable primary outcome measure | Low risk | Falls and hospitalisations |
| Adequate protection against contamination | High risk | Randomised by patient therefore contamination possible |
| Other bias | Low risk | Appears to be free from other sources of bias |