{{htmlmetatags>
metatag-keywords=(Iatrogénie, Conciliation, Education thérapeutique, Réhospitalisation)
metatag-og:title=(Medication review interventions to reduce hospital readmissions in older people. Dautzenberg L, et al, J Am Geriatr Soc 2021.)
metatag-description=(Medication review interventions to reduce hospital readmissions in older people. Dautzenberg L, et al, J Am Geriatr Soc 2021.)
metatag-og:type=article
metatag-article:published_time=2021-03-07
metatag-article:modified_time=2021-03-07
}}
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~~NOTOC~~
{{pmid>addtt:33576506|Medication review interventions to reduce hospital readmissions in older people.}}
{{pmid>addhash_fr:33576506|Iatrogénie, Conciliation, Education_thérapeutique, Réhospitalisation}}
====== Medication review interventions to reduce hospital readmissions in older people. Dautzenberg L, et al, J Am Geriatr Soc 2021. ======
{{tag>Iatrogénie }}
{{tag>Conciliation, Education_thérapeutique, Réhospitalisation}}
* **Proposé le :** 07/03/2021 10:17:50
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{{tag>Proposé_à_relecture 2021-03 Non_attribué Non_finalisé}}
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===== Résumé et points clés =====
**Objective:** To assess the efficacy of medication review as an isolated intervention and with several co-interventions for preventing hospital readmissions in older adults.
**Methods:** Ovid MEDLINE, Embase, The Cochrane Central Register of Controlled Trials and CINAHL were searched for randomized controlled trials evaluating the effectiveness of medication review interventions with or without co-interventions to prevent hospital readmissions in hospitalized or recently discharged adults aged ≥65, until September 13, 2019. Included outcomes were "at least one all-cause hospital readmission within 30 days and at any time after discharge from the index admission."
**Results:** Twenty-five studies met the inclusion criteria. Of these, 11 studies (7,318 participants) contributed to the network meta-analysis (NMA) on all-cause hospital readmission within 30 days. Medication review in combination with (a) medication reconciliation and patient education (risk ratio (RR) 0.45; 95% confidence interval (CI) 0.26-0.80) and (b) medication reconciliation, patient education, professional education and transitional care (RR 0.64; 95% CI 0.49-0.84) were associated with a lower risk of all-cause hospital readmission compared to usual care. Medication review in isolation did not significantly influence hospital readmissions (RR 1.06; 95% CI 0.45-2.51). The NMA on all-cause hospital readmission at any time included 24 studies (11,677 participants). Medication review combined with medication reconciliation, patient education, professional education and transitional care resulted in a reduction of hospital readmissions (RR 0.82; 95% CI 0.74-0.91) compared to usual care. The quality of the studies included in this systematic review raised some concerns, mainly regarding allocation concealment, blinding and contamination.
**Conclusion:** Medication review in combination with medication reconciliation, patient education, professional education and transitional care, was associated with a lower risk of hospital readmissions compared to usual care. An effect of medication review without co-interventions was not demonstrated. Trials of higher quality are needed in this field.
===== Références de l'article =====
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