Key result
Medication reviews in hospitalised patients significantly reduced the risk of hospital readmissions compared to usual care (RR 0.92; 95% CI 0.88-0.97; p=0.002).
Why the study?
Efforts to reduce preventable medication-related harm through medication reviews have increased, but interventions often yield null results regarding clinical outcomes.
Do medication reviews reduce hospital readmissions and all-cause mortality in hospitalized patients?
Meta-Analysis (n=12,539)
Do medication reviews reduce hospital readmissions and all-cause mortality in hospitalized patients?
Relative Risk: 0.92 (95% CI 0.88–0.97)
p-value: p=0.002
Medication reviews, particularly those with multiple patient contacts involving pharmacists, significantly reduce the risk of hospital readmission and may reduce all-cause mortality when comprehensively assessed.
Supports routine medication reviews at discharge to reduce readmissions; confirms benefit and suggests mortality reduction with complete ascertainment.
Efforts to reduce preventable medication-related harm through medication reviews have increased, but interventions often yield null-results regarding clinical outcomes. We conducted a systematic literature search in four data bases and summarised the available evidence from randomised controlled trials (RCTs) comparing medication reviews and usual care in hospitalised patients regarding hospital readmissions and all-cause mortality by random-effects meta-analyses. Effect size differences by methodological study differences were of special interest. The meta-analysis of all 24 trials on hospital readmissions, including 12,539 participants, showed a statistically significant 8% decrease in hospital readmissions (risk ratio (RR) [95% confidence interval]: (0.92 [0.88–0.97], p=0.002). The number of patient contacts was the most prominent effect modifier in meta-regression (p=0.003) and the effect of medication reviews was approximately twice as strong (15%) in 11 trials with 2 or more patient contacts (0.85 [0.78–0.92], p<0.001). No statistically significant reduction in all-cause mortality was observed in a meta-analysis of all 22 trials with data for this outcome (0.95 [0.86–1.04], p=0.24), including 12,350 participants. The method of mortality assessment was identified as an effect modifier by meta-regression (p=0.01). A meta-analysis of 10 trials with complete mortality ascertainment via registries or primary care data showed a significantly 19% reduced mortality (0.81 [0.70–0.94], p<0.01)). In conclusion, medication reviews reduce the risk of hospital readmission and might also reduce all-cause mortality. Comprehensive mortality assessment was essential for successful trials. Clinical guidelines should recommend medication reviews with multiple patient contacts, involving pharmacists, either for repeated medication reviews or to improve adherence. • Most RCTs, testing medication reviews, yielded null-results for clinical outcomes • Meta-analysis on 24 trials on hospital readmission and 22 trials on mortality • In meta-analysis, medication reviews reduce risk of hospital readmission • Medication reviews reduce mortality in trials with complete mortality assessment • Multiple patient contacts and involving pharmacists were particularly effective
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Degen et al. (2025) conducted a meta-analysis in Hospitalised patients (n=12,539). Medication reviews vs. Usual care was evaluated on Hospital readmissions (RR 0.92, 95% CI 0.88-0.97, p=0.002). Medication reviews in hospitalised patients significantly reduced the risk of hospital readmissions compared to usual care (RR 0.92; 95% CI 0.88-0.97; p=0.002).
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