| Outcomes | No of Participants (studies) Follow up | Quality of the evidence (GRADE) | Relative effect (95% CI) | Anticipated absolute effects | |
|---|---|---|---|---|---|
| Risk with no ward-based pharmacist | Risk difference with Regular in-hospital pharmacist support (95% CI) | ||||
| Mortality |
1060 (3 studies) 1 years |
⊕⊝⊝⊝ due to risk of bias, imprecision | RR 0.92 (0.72 to 1.16) | 198 per 1000 |
16 fewer per 1000 (from 55 fewer to 32 more) |
| Survival |
368 (1 study) 1 years |
⊕⊝⊝⊝ due to risk of bias, imprecision | HR 0.94 (0.65 to 1.36) | Control group risk not provided | Absolute effect cannot be calculated |
| Future admissions to hospital (over 30 days) |
1892 (4 studies) 1 years |
⊕⊕⊕⊝ MODERATEa due to risk of bias | RR 0.93 (0.83 to 1.04) | 384 per 1000 |
27 fewer per 1000 (from 65 fewer to 15 more) |
| Readmission |
592 (1 study) 30 days |
⊕⊝⊝⊝ due to risk of bias, imprecision | RR 0.92 (0.62 to 1.37) | 146 per 1000 |
12 fewer per 1000 (from 55 fewer to 54 more) |
| Prescribing errors medication appropriateness index |
811 (2 studies) at discharge |
⊕⊕⊕⊝ due to risk of bias, inconsistency | - | - |
The mean prescribing errors in the intervention groups was 0.02 lower (0.12 lower to 1.08 higher) |
| Prescribing errors medication appropriateness index |
613 (1 study) 30 days |
⊕⊕⊕⊝ MODERATEa due to risk of bias | - |
The mean prescribing errors in the control groups was 9.6 |
The mean prescribing errors in the intervention groups was 2.1 higher (0.45 to 3.75 higher) |
| Preventable adverse drug events |
790 (2 studies) until discharge |
⊕⊝⊝⊝ due to risk of bias, inconsistency, imprecision | RR 0.74 (0.06 to 8.57) | 54 per 1000 |
14 fewer per 1000 (from 51 fewer to 409 more) |
| Preventable adverse drug events |
588 (1 study) 90 days |
⊕⊝⊝⊝ due to risk of bias, imprecision | RR 0.77 (0.29 to 2.05) | 31 per 1000 |
7 fewer per 1000 (from 22 fewer to 33 more) |
| Adverse drug reactions |
85 (1 study) 6 months |
⊕⊝⊝⊝ due to risk of bias, imprecision | RR 1.47 (0.26 to 8.33) | 48 per 1000 |
23 more per 1000 (from 36 fewer to 352 more) |
| Length of stay (days) |
1116 (2 studies) in-hospital |
⊕⊕⊕⊝ MODERATEa due to risk of bias |
The mean length of stay in the control groups was 17.8 days |
The mean length of stay in the intervention groups was 1.74 lower (2.76 to 0.72 lower) | |
| Patient and/or carer satisfaction (1 month follow-up) |
172 (1 study) 1 months |
⊕⊕⊝⊝ LOWa due to risk of bias | RR 1.79 (1.38 to 2.32) | 446 per 1000 |
352 more per 1000 (from 169 more to 589 more) |
| Patient and/or carer satisfaction (at discharge) |
85 (1 study) at discharge |
⊕⊕⊝⊝ due to risk of bias, imprecision | RR 1.49 (1.09 to 2.03) | 548 per 1000 |
269 more per 1000 (from 49 more to 564 more) |
Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias.
Downgraded by 1 increment if the confidence interval crossed 1 MID or by 2 increments if the confidence interval crossed both MIDs.
Downgraded by 1 because: The point estimate varies widely across studies, unexplained by subgroup analysis.
From: Chapter 30, Pharmacist support
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.