Medication reviews by clinical pharmacists at hospitals lead to improved patient outcomes: a systematic review

Basic Clin Pharmacol Toxicol. 2013 Jun;112(6):359-73. doi: 10.1111/bcpt.12062. Epub 2013 Apr 6.


Suboptimal medication use may lead to morbidity, mortality and increased costs. To reduce unnecessary patient harm, medicines management including medication reviews can be provided by clinical pharmacists. Some recent studies have indicated a positive effect of this service, but the quality and outcomes vary among studies. Hence, there is a need for compiling the evidence within this area. The aim of this systematic MiniReview was to identify, assess and summarize the literature investigating the effect of pharmacist-led medication reviews in hospitalized patients. Five databases (MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Library) were searched from their inception to 2011 in addition to citation tracking and hand search. Only original research papers published in English describing pharmacist-led medication reviews in a hospital setting including minimum 100 patients or 100 interventions were included in the final assessment. A total of 836 research papers were identified, and 31 publications were included in the study: 21 descriptive studies and 10 controlled studies, of which 6 were randomized controlled trials. The pharmacist interventions were well implemented with acceptance rates from 39% to 100%. The 10 controlled studies generally show a positive effect on medication use and costs, satisfaction with the service and positive as well as insignificant effects on health service use. Several outcomes were statistically insignificant, but these were predominantly associated with low sample sizes or low acceptance rates. Therefore, future research within this area should be designed using rigorous design, large sample sizes and includes comparable outcome measures for patient health outcomes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Drug Prescriptions / standards*
  • Drug Prescriptions / statistics & numerical data
  • Humans
  • Inappropriate Prescribing / prevention & control*
  • Inappropriate Prescribing / statistics & numerical data
  • Medication Reconciliation
  • Pharmacists*
  • Pharmacy Service, Hospital / standards*
  • Pharmacy Service, Hospital / statistics & numerical data
  • Randomized Controlled Trials as Topic
  • Treatment Outcome