Medication Counselling in Older Patients Prior to Hospital Discharge: A Systematic Review
- PDF / 832,320 Bytes
- 21 Pages / 595.276 x 790.866 pts Page_size
- 43 Downloads / 232 Views
SYSTEMATIC REVIEW
Medication Counselling in Older Patients Prior to Hospital Discharge: A Systematic Review Andreas Capiau1,2 · Katrien Foubert2 · Lorenz Van der Linden3,4 · Karolien Walgraeve3 · Julie Hias3 · Anne Spinewine5,6 · Anne‑Laure Sennesael6 · Mirko Petrovic7,8 · Annemie Somers1,2 on behalf of the Belgian Society for Gerontology and Geriatrics (BSGG)
© Springer Nature Switzerland AG 2020
Abstract Background Older patients are regularly exposed to multiple medication changes during a hospital stay and are more likely to experience problems understanding these changes. Medication counselling is often proposed as an important component of seamless care to ensure appropriate medication use after hospital discharge. Objectives The purpose of this systematic review was to describe the components of medication counselling in older patients (aged ≥ 65 years) prior to hospital discharge and to review the effectiveness of such counselling on reported clinical outcomes. Methods Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology (PROSPERO CRD42019116036), a systematic search of MEDLINE, EMBASE and CINAHL was conducted. The QualSyst Assessment Tool was used to assess bias. The impact of medication counselling on different outcomes was described and stratified by intervention content. Results Twenty-nine studies were included. Fifteen different components of medication counselling were identified. Discussing the dose and dosage of patients’ medications (19/29; 65.5%), providing a paper-based medication list (19/29; 65.5%) and explaining the indications of the prescribed medications (17/29; 58.6%) were the most frequently encountered components during the counselling session. Twelve different clinical outcomes were investigated in the 29 studies. A positive effect of medication counselling on medication adherence and medication knowledge was found more frequently, compared to its impact on hard outcomes such as hospital readmissions and mortality. Yet, evidence remains inconclusive regarding clinical benefit, owing to study design heterogeneity and different intervention components. Statistically significant results were more frequently observed when counselling was provided as part of a comprehensive intervention before discharge. Conclusions Substantial heterogeneity between the included studies was found for the components of medication counselling and the reported outcomes. Study findings suggest that medication counselling should be part of multifaceted interventions, but the evidence concerning clinical outcomes remains inconclusive.
1 Introduction Older patients are regularly exposed to a multitude of medication changes during a hospital stay, mostly owing to newly diagnosed conditions or drug therapy optimisation [1–5]. However, such drug regimen changes and resulting polypharmacy might put patients at risk of drug-related problems Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40266-020-00780-z) contains su
Data Loading...
