Interventions to Enhance Medication Safety in Residential Aged-care Settings: An Umbrella Review

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Alruthea, Shadi
Bowman, Paula
Tariq, Amina
Hinchcliff, Reece
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2022
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Abstract

Aim: To conduct a systematic synthesis of existing evidence reviews on interventions to enhance medication safety in residential aged-care settings (RACS) to establish and compare their effectiveness. Method: This umbrella review included examination of meta-analyses, scoping and systematic reviews. Four electronic databases were examined for eligible reviews. Two authors critically appraised those meeting the inclusion criteria using the Joanna Briggs Institute Critical Appraisal Instrument. Results: Fifteen reviews covering 171 unique, primary studies were included. Of the variety of interventions identified in the literature, five main categories of interventions were commonly reported to be effective in promoting medication safety in RACS (medication review, staff education, multidisciplinary team meetings, computerised clinical decision support systems and miscellaneous). Most reviews showed mixed evidence to support intervention effectiveness due to the significant heterogeneity between studies in their sites, sample sizes and intervention periods. In all intervention categories, pharmacists' collaboration was most beneficial, showing definitive evidence for improving medication safety and quality of prescribing in RACS. Eight reviews recommended multicomponent interventions, particularly medication reviews and staff education, but specific details were infrequently provided. Only five reviews presented insights into implementation facilitators and barriers, while the sustainability of interventions was only discussed in one review. Conclusion: There is strong evidence to support the four main categories of interventions identified. However, limited details are available regarding the most appropriate design and implementation of multicomponent interventions and the sustainability of all interventions, thus solid recommendations cannot be made. Future research in this field should focus on producing theoretically informed, methodologically robust, original research, particularly regarding the design, implementation and sustainability of multicomponent interventions, which appears the most promising approach.

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British Journal of Clinical Pharmacology

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88

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4

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© 2021 British Pharmacological Society. This is the peer reviewed version of the following article: Alruthea, S; Bowman, P; Tariq, A; Hinchcliff, R, Interventions to Enhance Medication Safety in Residential Aged-care Settings: An Umbrella Review, British Journal of Clinical Pharmacology, 2022, 88 (4), pp. 1630-1643, which has been published in final form at https://doi.org/10.1111/bcp.15109. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

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Subject

Pharmacology and pharmaceutical sciences

Science & Technology

Life Sciences & Biomedicine

Pharmacology & Pharmacy

aged care

intervention

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Alruthea, S; Bowman, P; Tariq, A; Hinchcliff, R, Interventions to Enhance Medication Safety in Residential Aged-care Settings: An Umbrella Review, British Journal of Clinical Pharmacology, 2022, 88 (4), pp. 1630-1643

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