Table 7, Clinical evidence summary: Pharmacist at discharge compared to no ward-based pharmacist - Emergency and acute medical care in over 16s: service delivery and organisation

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Table 7Clinical evidence summary: Pharmacist at discharge compared to no ward-based pharmacist

Outcomes	No of Participants (studies) Follow up	Quality of the evidence (GRADE)	Relative effect (95% CI)	Anticipated absolute effects
Quality of life Global health index	204 (1 study) 6 months	⊕⊝⊝⊝ VERY LOW^a^,^b due to risk of bias, imprecision		The mean quality of life in the control groups was 2.77	The mean quality of life in the intervention groups was 0.23 higher (0.02 lower to 0.48 higher)
Quality of life Summated EQ-5D index	204 (1 study) 6 months	⊕⊕⊝⊝ LOW^a due to risk of bias		The mean quality of life in the control groups was 0.43	The mean quality of life in the intervention groups was 0.05 higher (0.05 lower to 0.15 higher)
Quality of life EQ-VAS index. Scale from: 0 to 100.	204 (1 study) 6 months	⊕⊕⊝⊝ LOW^a due to risk of bias		The mean quality of life in the control groups was 56.3	The mean quality of life in the intervention groups was 2.8 higher (1.83 lower to 7.43 higher)
Prescription errors identification at outpatient follow-up	85 (1 study) 6 weeks	⊕⊝⊝⊝ VERY LOW^a^,^b due to risk of bias, imprecision	RR 0.57 (0.37 to 0.88)	682 per 1000	293 fewer per 1000 (from 82 fewer to 430 fewer)
Readmission	83 (1 study) 15-22 days	⊕⊕⊝⊝ LOW^a^,^b due to risk of bias, imprecision	RR 0.36 (0.14 to 0.91)	325 per 1000	208 fewer per 1000 (from 29 fewer to 279 fewer)
Prescriber errors (drug therapy inconsistencies and omissions)	147 (1 study) at discharge	⊕⊕⊕⊝ MODERATE^a due to risk of bias	RR 0.06 (0.01 to 0.44)	563 per 1000	529 fewer per 1000 (from 315 fewer to 557 fewer)

Outcomes

No of Participants (studies) Follow up

Quality of the evidence (GRADE)

Relative effect (95% CI)

Anticipated absolute effects

Risk with no ward-pharmacist

Risk difference with pharmacist at discharge (95% CI)

Quality of life

Global health index

204

(1 study)

6 months

⊕⊝⊝⊝

VERY LOW^a^,^b

due to risk of bias, imprecision

The mean quality of life in the control groups was

2.77

The mean quality of life in the intervention groups was

0.23 higher

(0.02 lower to 0.48 higher)

Quality of life

Summated EQ-5D index

204

(1 study)

6 months

⊕⊕⊝⊝

LOW^a

due to risk of bias

The mean quality of life in the control groups was

0.43

The mean quality of life in the intervention groups was

0.05 higher

(0.05 lower to 0.15 higher)

Quality of life

EQ-VAS index. Scale from: 0 to 100.

204

(1 study)

6 months

⊕⊕⊝⊝

LOW^a

due to risk of bias

The mean quality of life in the control groups was

56.3

The mean quality of life in the intervention groups was

2.8 higher

(1.83 lower to 7.43 higher)

Prescription errors identification at outpatient follow-up

(1 study)

6 weeks

⊕⊝⊝⊝

VERY LOW^a^,^b

due to risk of bias, imprecision

RR 0.57 (0.37 to 0.88)

682 per 1000

293 fewer per 1000

(from 82 fewer to 430 fewer)

Readmission

(1 study)

15-22 days

⊕⊕⊝⊝

LOW^a^,^b

due to risk of bias, imprecision

RR 0.36 (0.14 to 0.91)

325 per 1000

208 fewer per 1000

(from 29 fewer to 279 fewer)

Prescriber errors (drug therapy inconsistencies and omissions)

147

(1 study)

at discharge

⊕⊕⊕⊝

MODERATE^a

due to risk of bias

RR 0.06 (0.01 to 0.44)

563 per 1000

529 fewer per 1000

(from 315 fewer to 557 fewer)

(a): 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.
(b): Downgraded by 1 increment if the confidence interval crossed 1 MID or by 2 increments if the confidence interval crossed both MIDs.

From: Chapter 30, Pharmacist support

Emergency and acute medical care in over 16s: service delivery and organisation.

NICE Guideline, No. 94.

National Guideline Centre (UK).

London: National Institute for Health and Care Excellence (NICE); 2018 Mar.

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