A randomized controlled study found that pharmacist counseling failed to reduce clinically important medication errors and adverse drug events in patients recently discharged from the hospital.
Adverse drug effects (ADEs) are thought to affect 11% to 17% of patients during the first few weeks after they leave the hospital. To determine whether pharmacist intervention could help reduce the occurrence of clinically important medication errors and ADEs after discharge from the hospital, researchers ran a randomized controlled study including heart condition patients at Vanderbilt University Hospital in Nashville and Brigham and Women’s Hospital in Boston. Their results
were published in the July 3, 2012, edition of Annals of Internal Medicine
All participants in the study received usual care, including medication reconciliation. The participants in the intervention group also received inpatient pharmacist counseling, low-literacy adherence aids, and individualized telephone follow-up several days after discharge. Among 851 patients, 432 (50.8%) had at least 1 clinically important medication error within 30 days of discharge, with 22.9% of errors deemed serious and 1.8% life-threatening. At least 1 ADE occurred in 258 patients (30.3%), and at least 1 potential ADE occurred in 253 patients (29.7%).
Intervention did not significantly reduce clinically important medication errors or ADEs. It did tend to reduce the number of potential ADEs in all participants and the number of clinically important medication errors in a subgroup of patients with inadequate health literacy, although the difference did not reach statistical significance in either case.
The researchers note that the effects of intervention may have been blunted by the fact that the participants were well educated and had a relatively low prevalence of inadequate health literacy, which the intervention was designed to address. In addition, both hospitals involved had medication reconciliation services in place, which were included in the usual care provided to all participants in the study.