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@ARTICLE{Degen:296216,
author = {M. Degen$^*$ and L.-J. Chen$^*$ and B. Schöttker$^*$},
title = {{M}edication reviews in hospitalised patients for reduced
hospital readmission and mortality. {S}ystematic review,
meta-analysis and meta-regression of {RCT}s.},
journal = {Ageing research reviews},
volume = {104},
issn = {1568-1637},
address = {Oxford [u.a.]},
publisher = {Elsevier},
reportid = {DKFZ-2025-00129},
pages = {102661},
year = {2025},
note = {#EA:C070#LA:C070# / 2025 Feb;104:102661},
abstract = {Efforts to reduce preventable medication-related harm
through medication reviews have increased, but interventions
often yield null-results regarding clinical outcomes. We
conducted a systematic literature search in four data bases
and summarised the available evidence from randomised
controlled trials (RCTs) comparing medication reviews and
usual care in hospitalised patients regarding hospital
readmissions and all-cause mortality by random-effects
meta-analyses. Effect size differences by methodological
study differences were of special interest. The
meta-analysis of all 24 trials on hospital readmissions,
including 12,539 participants, showed a statistically
significant $8\%$ decrease in hospital readmissions (risk
ratio (RR) $[95\%$ confidence interval]: (0.92 [0.88-0.97],
p=0.002). The number of patient contacts was the most
prominent effect modifier in meta-regression (p=0.003) and
the effect of medication reviews was approximately twice as
strong $(15\%)$ in 11 trials with 2 or more patient contacts
(0.85 [0.78-0.92], p<0.001). No statistically significant
reduction in all-cause mortality was observed in a
meta-analysis of all 22 trials with data for this outcome
(0.95 [0.86-1.04], p=0.24), including 12,350 participants.
The method of mortality assessment was identified as an
effect modifier by meta-regression (p=0.01). A meta-analysis
of 10 trials with complete mortality ascertainment via
registries or primary care data showed a significantly
$19\%$ reduced mortality (0.81 [0.70-0.94], p<0.01)). In
conclusion, medication reviews reduce the risk of hospital
readmission and might also reduce all-cause mortality.
Comprehensive mortality assessment was essential for
successful trials. Clinical guidelines should recommend
medication reviews with multiple patient contacts, involving
pharmacists, either for repeated medication reviews or to
improve adherence.},
subtyp = {Review Article},
keywords = {Hospitalizations (Other) / Medication Review (Other) /
Mortality (Other) / Polypharmacy (Other) / Randomized
Controlled Trial (Other) / Systematic Review (Other)},
cin = {C070},
ddc = {610},
cid = {I:(DE-He78)C070-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39805472},
doi = {10.1016/j.arr.2025.102661},
url = {https://inrepo02.dkfz.de/record/296216},
}