Table 2.
Summary of study characteristics
| Study | Participants (I= intervention arm; C= control arm) | Intervention components coded using taxonomy | Provider | Control | Outcome measure | |
|---|---|---|---|---|---|---|
| Age = years to nearest whole | Result | Overall effect | ||||
| Interventions offered during hospital admission | ||||||
| Basger et al. [29] | n = 216 | E/S/MR/CR/CSC | Pharmacist | Usual care | MRP detection between follow-up and discharge; (0.09 ≤ P ≤ 0.97) | No difference |
| I: 114 | QoL; I: +18.6 versus C: +15.3 (P < 0.001) | Favours intervention | ||||
| C: 102 | ||||||
| Mean age = 81 | ||||||
| Bolas et al. [31] | n = 162 | E/MR/D/CSC/H | Pharmacist | Usual care | Readmissions (3 month); figures NR (P > 0.05) | No difference |
| I: 81 | Error (drug name); I: 1.5% versus C: 7% (P < 0.005) | Favours intervention | ||||
| C: 81 | Error (drug dose); I: 10% versus C: 17% (P < 0.07) | No difference | ||||
| Mean age = 74 | Error (dose frequency); I: 11% versus C: 18% (P < 0.004) | Favours intervention | ||||
| Graabaek et al. [35] | n = 400 | E/MR/CR/C | Pharmacist | Usual care | Readmissions (1 month); I: 30 (15%) versus C: 36 (18%) (P = 0.72) | No difference |
| I: 200 | Mortality (3 month); I: 13 (6.5%) versus C: 16 (8%) (P = 0.6) | No difference | ||||
| C: 200 | ||||||
| Mean age = 75 | ||||||
| Hockley et al. [27] | n = 33I: 17 | CSC | Pharmacist | Usual care | Incidence of discrepancy (GP data); I: 25 (14%) versus C: 50 (26%) (P = 0.00034) | Favours intervention |
| C: 16Mean age = 66 | Incidence of discrepancy (patient reported); I: 10 (8%) versus C: 31 (23%) (P = 0.000043) | Favours intervention | ||||
| Lalonde et al. [32] | n = 83 | D/C/CSC | Pharmacist | Usual care | Error rate; I: 13.2% versus C: 15.3% (P = 0.6) | No difference |
| I: 42 | ||||||
| C: 41 | ||||||
| Mean age = 71 | ||||||
| Legrain et al. [34] | n = 665 | E/S/MR/CR/C/CSC | Geriatrician | Usual care | Readmission (3 month); I: 64 (20.2%) versus C: 99 (28.4%) (P = 0.01) | Favours intervention |
| I: 317 | Readmission (6 month); I: 103 (32.5%) versus C: 133 (38%) (P = 0.12) | No difference | ||||
| C: 348 | Mortality (6 month); I: 56 (17.7%) versus C: 65 (18.7%) (P = 0.74) | No difference | ||||
| Mean age = 85 | ||||||
| Scullin et al. [33] | n = 762 | E/MR/CR/D/CSC | Pharmacist and pharmacy technician | Usual care | Readmission (12 month); I: 141 (38%) versus C: 172 (44%) (P = 0.027) | Favours intervention |
| I: 371 | ||||||
| C: 391 | ||||||
| Mean age = 70 | ||||||
| Tamblyn et al. [25] | n = 4656 | MR/CSC | Electronic intervention | Usual care | Adverse drug event; I: 76 (4.6%) versus C: 73 (4%) (OR 0.24; CIs 0.33–1.48) | No difference |
| I: 2203 | Medication discrepancy; I: 437 (26.4%) versus C: 1029 (56%) (OR 0.24; CIs 0.12–0.57) | Favours intervention | ||||
| C: 2453 | Readmission (1 month); I: 170 (10.3%) versus C: 261 (14.2) (OR 0.22; CIs 0.06–1.14) | No difference | ||||
| Mean age = 70 | Readmission (3 month); I: 292 (17.6%) versus C: 433 (23.6%) (OR 0.37; CIs 0.11–1.40) | No difference | ||||
| Tong et al. [30] | n = 832 | D | Pharmacist | Usual care | Error rate; I: 15% versus C: 61.5% (P < 0.01) | Favours intervention |
| I: 401 | ||||||
| C: 431 | ||||||
| Mean age = 73 | ||||||
| Interventions commenced during hospital admission that include continuing support post-discharge | ||||||
| Buurman et al. [36, 64] | n = 674 | V/E/MR/C/CSC | Nurse | Usual care | Readmission (6 month); I: 106 (33.5%) versus C: 88 (29%) (P = NR) | No difference |
| I: 337 | Mortality (6 month); I: 85 (25.2%) versus C: 104 (30.9%) (P = 0.045) | Favours intervention | ||||
| C: 337 | ||||||
| Mean age = 80 | ||||||
| Casas et al. [37] | n = 155 | T/E/S/CSC | Nurse | Usual care | Readmission (12 month); I: 29 (45%) versus C: 60 (67%) (P = 0.028) | Favours intervention |
| I: 65 | Mortality (12 month); I: 12 (19%) versus C: 14 (16%) (P = 0.67) | No difference | ||||
| C: 90 | ||||||
| Mean age = 71 | ||||||
| Chan et al. [26] | n = 699 | T/E/S/MR/D/H | Nurse | Usual care | Care Transitions Measure-3 score; I: 80.5% versus C: 78.5% (P = 0.18) | No difference |
| I: 347 | ||||||
| C: 353 | ||||||
| Mean age = 66 | ||||||
| Coleman et al. [39] | n = 750 | T/V/E/S/MR/D | Nurse | Usual care | Readmission (1 month); I: 31 (8.3%) versus C: 44 (11.9%) (P = 0.048) | Favours intervention |
| I: 379 | Readmission (3 month); I: 63 (16.7%) versus C: 83 (22.5%) (P = 0.04) | Favours intervention | ||||
| C: 371 | Readmission (6 month); I: 97 (25.6%) versus C: 114 (30.7%) (P = 0.28) | No difference | ||||
| Mean age = 76 | ||||||
| Gillespie et al. [28] | n = 400I: 199C: 201Mean age = 86 | T/E/MR/CR/C/CSC | Pharmacist | Usual care | Readmission (12 month); I: 106 (58.2%) versus C: 110 (59.1%) (OR 0.96; CIs 0.64–1.46)Drug related readmission; I: 9 (4.9%) versus C: 45 (24%) (OR 0.20; CIs 0.10–0.41) | No differenceFavours intervention |
| Huang et al. [40] | n = 126 | T/V/E/D/C/CSC/H | Nurse | Usual care | Readmission (3 month); I: 4 (6.35%) versus C: 13 (20.6%) (P = 0.02) | Favours intervention |
| I: 63 | QoL; I: +18.6 versus C: +15.3 (P < 0.001) | Favours intervention | ||||
| C: 63 | ||||||
| Mean age = 77 | ||||||
| Koehler et al. [38] | n = 41I: 20C: 21 | T/E/S/MR/CR/D/CSC | Nurse and pharmacist | Usual care | Readmission (1 month); I: 2 (10%) versus C: 8 (38%) (P = 0.03)Readmission (2 month); I: 4 (20%) versus C: 1 (5%) (P = 0.18) | Favours interventionNo difference |
| Mean age = 79 | ||||||
| Lee et al. [41, 65] | n = 840I: 420C: 420Mean age = 69 | T/V/E/MR/CR/D/C/CSC | Multidisciplinary team | Usual care | Readmission (1 month); I: 117 (28.5%) versus C: 139 (33%) (P = 0.124)Readmission (2 month); I: 183 (44.5%) versus C: 186 (44%) (P = 0.957)Readmission (3 month); I: 214 (52%) versus C: 225 (54%) (P = 0.561)Mortality; HR 0.72; CIs 0.61–0.86; P < 0.001 | No differenceNo differenceNo differenceFavours intervention |
| Ravn-Nielsen et al. [42] | n = 974I: 476C: 498Mean age = NR | T/E/S/MR/CR/C/CSC | Pharmacist | Usual care | Readmission (1 month); I: 68 (14.3%) versus C: 111 (22.3%) (HR 0.62; CIs 0.46–0.84)Readmission (6 month); I: 189 (39.7%) versus C: 243 (48.8%) (HR; 0.75 CIs 0.62–0.9)Mortality (6 month); I: 54 (11.3%) versus C: 50 (10%) (HR 1.05; CIs 0.68–1.63) | Favours interventionFavours interventionNo difference |
| Interventions commenced post-discharge | ||||||
| Ahmad et al. [43, 48] | n = 340I: 180C: 160Mean age = 70 | V/E/MR/CR/C | Pharmacist and pharmacy technician | Usual care | MRPs: (mean number of problems) I: 1.51 baseline to 1.37 follow up versus C: 1.58 to 1.62 (P = NR) | No difference |
| Char et al. [46] | n = 200I: 100C: 100Mean age = 74 | MR/C | Pharmacist | Usual care | Errors: (number) I: 15 (15.8%) versus C: 54 (57.4%) (P < 0.001)Readmission (1 month); I: 6 (6%) versus C: 4 (4%) (P = NR) | Favours interventionNo difference |
| Gurwitz et al. [45] | n = 3661I: 1870C: 1791Mean age = NR | CSC | Automated electronic system | Usual care | Readmission (1 month); I: 351 (18.8%) versus C: 356 (19.9%) (HR 0.94; CIs 0.91–1.1) | No difference |
| Haag et al. [24] | n = 25I: 13C: 12Mean age = 84 | T/MR/CR/C | Pharmacist | Usual care | Readmission (1 month); I: 2 (18%) versus C: 1 (9%) (P = 0.53)Medication appropriateness1 (30 day); I: 10 (91%) versus C: 10 (91%) (P > 0.99)Medication appropriateness 2 (30 day); I: 8 (73%) versus C: 10 (91%) (P = 0.31)Medication appropriateness 3 (30 day); I: 9 (82%) versus C: 10 (91%) (P = 0.55) | No differenceNo differenceNo differenceNo difference |
| Holland et al. [47] | n = 872I: 437C: 435Mean age = 85 | V/E/CR/C/CSC | Pharmacist | Usual care | Readmission (6 month); I: 234 (54.5%) versus C: 178 (41.8%) (P = 0.009)QoL; I: −0.131 versus C: −0.137 (P = 0.84)Visual analogue scale I: −7.36 versus C: −3.24 (P = 0.042) | Favours controlNo differenceFavours control |
| Tuttle et al. [44, 66] | n = 159 | V/E/S/MR/CR/C | Pharmacist | Usual care | Readmission (3 month); I: 19 (26%) versus C: 18 (26%) (P = 0.95) | No difference |
| I: 84 | ||||||
| C: 75 | ||||||
| Mean age = 69 | ||||||
C, collaboration within care team; CIs, confidence intervals; CR, clinical review; CSC, timely cross-sector communication; D, patient-centred discharge document; E, education; H, home visit; HR, hazard ratio; MR, medication reconciliation; MRP, Medication-related problem; NR, not reported; QoL, quality of life; S, self-management (education or coaching); T, telephone follow-up; V, home visit.