Effect of a Multifaceted Clinical Pharmacist Intervention on Medication Safety After Hospitalization in Persons Prescribed High-risk Medications: A Randomized Clinical Trial
RCT (n=361 at a practice in Massachusetts) did not show improvement in medication safety with a pharmacist-directed intervention during high-risk post-hospitalization period (81 adverse drug-related incidents in intervention vs. 72 control group over 45-day post discharge period)
Source:
JAMA Internal Medicine
SPS commentary:
The pharmacist-directed intervention included an in-home assessment by a clinical pharmacist, evidence-based educational resources, communication with the primary care team, and telephone follow-up. Participants in the control group were provided educational materials via mail.
According to a commentary, despite the large number of eligible participants, recruitment numbers were quite low, and eligibility criteria had to be expanded from patients aged 65 years or older to include patients aged 50 to 65 years to boost recruitment. Even with these broader inclusion criteria, the original goal of 500 participants was not met, leaving the study underpowered. It notes that while careful and coordinated postdischarge follow-up should undoubtedly continue, there is a need to also more carefully consider the medications being prescribed, especially at hospital discharge. It adds that the best way to prevent ADRs is to not prescribe a drug that is not truly necessary in the first place, which will aid the robust work that is focused on deprescribing medications once the patient has transitioned home.