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Interprofessional medication review shows non-significant improvement in prescribing appropriateness for older ED patientsMedication review for older emergency patients did not show clear benefit over standard care

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Key Takeaway
Consider that an interprofessional medication review may support deprescribing, but its effect on prescribing appropriateness was not statistically significant.

This randomized controlled trial evaluated a structured, patient-oriented, interprofessional medication review conducted by a clinical pharmacist and geriatrician versus standard care in 151 older adults (≥65 years) admitted to the emergency department of a Copenhagen hospital. The primary outcome was the change in the Medication Appropriateness Index (MAI) score from inclusion to the 8-week follow-up.

The intervention group showed a mean improvement of 2.2 points (SD 6.6) in MAI score, compared to 1.2 points (SD 5.5) in the control group, but this difference was not statistically significant (P = 0.3). Regarding deprescribing, 295 medications (18.6%) were deprescribed overall by the 8-week follow-up, with 170 (21.3%) in the intervention group and 125 (15.9%) in the control group.

Safety and tolerability data were not reported. Key limitations were not explicitly listed in the provided evidence. The study's practice relevance is restrained; while deprescribing was identified as an important strategy, the primary outcome did not show a statistically significant benefit over standard care. The intervention did not have a notable effect on the reported secondary outcomes.

Researchers wanted to see if a special medication review could make prescriptions safer for older adults arriving at the emergency department. They studied 151 patients aged 65 and older at a hospital in Denmark. Half received a structured review from a clinical pharmacist and a geriatrician, while the other half received the hospital's standard care. The main goal was to see if this review improved a score that measures how appropriate a patient's medications are.

After eight weeks, the group that got the special review did see a small improvement in their medication appropriateness score. However, this improvement was not statistically significant when compared to the group that received standard care. This means the difference could easily be due to chance. The review did lead to more medications being stopped, but this did not translate into a clear, measurable benefit in the study's main outcome.

No safety concerns from stopping medications were reported in the study. The main reason to be careful is that this single study did not provide strong evidence that this specific review process is more effective. Readers should understand that making medication plans safer for older, hospitalized patients is very important, but more research is needed to find the best way to do it. This study is a step in that process.

What this means for you:
A hospital medication review for older patients showed promise but needs more research to prove it works better than standard care.

Study Details

Study typeRct
EvidenceLevel 2
Follow-up1.8 mo
PublishedApr 2026
View Original Abstract ↓
AIMS: To evaluate the efficacy of a structured, patient-oriented, interprofessional medication review on inappropriate prescribing compared to standard care in the emergency department (ED). METHODS: In this protocolized analysis from a randomized controlled trial, 151 older adults (≥65 years) admitted to the ED of Copenhagen University Hospital Hvidovre, Denmark, between 2018 and 2021 were randomized to receive a medication review by a clinical pharmacist and geriatrician (intervention group [IG]) or standard care (control group [CG]). The primary outcome was the change in Medication Appropriateness Index (MAI) score from inclusion to 8-week follow-up. Efficacy was evaluated by analysis of covariance, adjusting for MAI score at inclusion. Secondary outcomes included change in the Assessment of Underutilization score, number of medications and number of potentially inappropriate medications. RESULTS: The mean (standard deviation) improvement in MAI score from inclusion to 8-week follow-up was 2.2 (6.6) points for the IG, compared to 1.2 (5.5) points for the CG (P = 0.3). The most common causes of inappropriate prescribing were lack of indication, incorrect dose and inappropriate duration of use. A total of 295 (18.6%) medications were deprescribed from inclusion to 8-week follow-up, including 170 (21.3%) in the IG and 125 (15.9%) in the CG. The intervention did not have a notable effect on secondary outcomes. CONCLUSIONS: The structured, patient-oriented, interprofessional medication review improved the MAI score at 8 weeks, but this improvement was not statistically significant compared to standard care. Deprescribing was identified as an important strategy for improving medication appropriateness and represents an important intervention for future research.
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