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National Guideline Centre (UK). Emergency and acute medical care in over 16s: service delivery and organisation. London: National Institute for Health and Care Excellence (NICE); 2018 Mar. (NICE Guideline, No. 94.)
Emergency and acute medical care in over 16s: service delivery and organisation.
Show detailsTable 6Clinical evidence summary: Pharmacist at admission 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 | |
---|---|---|---|---|---|
Risk with no ward-based pharmacist | Risk difference with pharmacist at admission (95% CI) | ||||
Medication errors identified at admission |
293 (2 studies) |
⊕⊕⊝⊝ due to risk of bias, imprecision |
The mean medication errors identified in the control groups was 1.51 |
The mean medication reconciliation in the intervention groups was 0.36 higher (0.07 to 0.65 higher) | |
Quality of life EQ-VAS index |
63 (1 study) 3 months |
⊕⊕⊝⊝ due to risk of bias, imprecision |
The mean quality of life in the control groups was 60.9 |
The mean quality of life in the intervention groups was 6.2 higher (5.7 lower to 18.1 higher) | |
Length of stay (hours) |
99 (1 study) in-hospital |
⊕⊕⊕⊝ MODERATEa due to risk of bias |
The mean length of stay in the control groups was 239.9 hours |
The mean length of stay in the intervention groups was 1.3 higher (108.96 lower to 111.56 higher) | |
Admissions |
99 (1 study) 3 months |
⊕⊕⊝⊝ due to risk of bias, imprecision |
The mean admission in the control groups was 0.4 admissions per patient |
The mean admission in the intervention groups was 0.1 lower (0.38 lower to 0.18 higher) | |
Mortality |
99 (1 study) 3 months |
⊕⊝⊝⊝ due to risk of bias, imprecision | RR 1.57 (0.55 to 4.46) | 102 per 1000 |
58 more per 1000 (from 46 fewer to 353 more) |
Physician agreement |
457 (1 study) at admission |
⊕⊝⊝⊝ due to risk of bias, indirectness, imprecision | RR 1.35 (1.13 to 1.63) | 437 per 1000 |
153 more per 1000 (from 57 more to 275 more) |
Length of stay in acute admissions unit (AAU) (minutes) |
448 (1 study) |
⊕⊕⊕⊝ MODERATE1 due to risk of bias | - | The mean length of stay in the control groups was 339 minutes. | The mean length of stay in intervention group was 3.2 min higher (26.49 lower to 32.89 higher) |
Total medication errors within 24 hours of admission |
881 (1 study) |
⊕⊕⊕⊝ MODERATE1 due to risk of bias | RR 0.05 (0.03 to 0.08) | 787 per 1000 | 748 fewer per 1000 (from 772 fewer to 763 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.
- (c)
The majority of the evidence had indirect outcomes.
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