Pharmacist’s interventions to reduce the occurrence of drug-related harms in older residents: a systematic review

Introduction. In residential aged care facilities (RACFs), there is little evidence concerning pharmacist interventions to prevent adverse drug events (ADEs) .

Aims. This study aimed to investigate the effectiveness of pharmacist’s interventions to reduce ADEs in older people permanently living in RACFs.

Methods. We performed a systematic search of MEDLINE via PubMed, Embase, Cochrane Central Register of Controlled Trials, and PsycINFO from the start to July 2020. We investigated pharmacist-led study designs that used a control group, or before and after studies conducted in RACFs.

Results. We found 23 studies from 3826 records. There were 7 single-component and 16 multicomponent pharmacist-led interventions aiming to reduce ADEs in older residents. The most frequent single-component pharmacist-led intervention was medication review. Medication review and the provision of education to healthcare professionals were the most common elements in many pharmacist-led multicomponent interventions. Ten studies (43%) reported substantial reductions in ADEs following pharmacist’s interventions either as a single intervention or as a part of a multicomponent intervention. Many interventions were designed to reduce falls (39%).

Discussion. The review shows that pharmacist’s interventions can reduce the occurrence of ADEs in RACFs. Medication review and educational programs, such as academic detailing, either as a single component or a part of multicomponent interventions, were the most common methods employed to reduce drug-related harm in older residents of RACFs. The lack of a positive association between interventions and ADEs in some studies suggests that targeted and customised pharmacist’s interventions are required to reduce drug-related harm in older residents.