Medication reviews do not reduce mortality and hospitalization among nursing home residents

Wallerstedt SM, Kindblom JM, Nylen K, et al.  Medication reviews for nursing home residents to reduce mortality and hospitalisation: Systematic review and meta-analysis British Journal of Clinical Pharmacology. 2014;78(3):488-497.

Review question

Can medication reviews reduce mortality and hospitalization among nursing home residents?

Background

Drug treatment in older people with multiple diseases and long medication lists is a challenge.

Inappropriate prescribing and use of drugs has been linked with a large proportion of hospital admissions and adverse drug reactions.

Medication reviews that assess the appropriateness of the drugs that have been prescribed to patients by their healthcare providers have been proposed as a way to improve prescribing practices and to ensure the appropriate use of medications.

How the review was done

Systematic searches of published and unpublished studies covering the period of January 1990 to June 2012 were conducted.

1,281 unique studies were identified from the searches, and after being assessed for inclusion, 12 studies were included.

The authors did not report the source of funding that supported this review.

What the researchers found

Medication reviews performed by pharmacists or multi-professional teams for older people living in nursing homes do not appear to have any beneficial effects on rates of mortality or hospitalization.

While there may be other benefits associated with medication reviews, it is not clear from the literature what these benefits might be.

Conclusion

Medication reviews do not appear to reduce mortality and hospitalization among nursing home residents and there is little evidence to suggest any other benefits of medication reviews.

Older adults living in nursing homes should not expect that the hospitalization and mortality risks associated with drug treatments will be reduced if their healthcare provider is subjected to a medication review that assesses the appropriateness of the drugs they have been prescribed.

This summary is based on a review that was determined to be of medium methodological quality based on an assessment using the AMSTAR tool.