The review objective is to identify and synthesise the best available evidence on effects of medication reconciliation strategies on medication errors among community dwelling older adults.

The review question is: What is the effectiveness of medication reconciliation strategies on medication errors among community dwelling older adults?

The search strategy aims to find both published and unpublished studies. A three-step search strategy will be utilised in this review. An initial limited search of MEDLINE and CINAHL will be undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. Studies published in the English language will be considered for inclusion in this review. Search timeframe is from the inception of databases to current date.

The databases to be searched include:

PubMed, CINAHL, The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Premiere, PsycINFO, and Healthsource: Nursing/Academic edition.

The search for unpublished studies will include:

Science.gov, scricus.com, Robert Wood Johnson Institute, Dissertations Abstract International.

Initial keywords to be used will be:

Medication errors, medication reconciliation, older adults

This review will consider randomised controlled trials, non-randomised controlled trials, and, quasi-experimental study designs including before and after studies. In the absence of the above other study designs including case control, cohort, and cross-sectional will be considered.

A medication error is a preventable action that may precipitate inappropriate medication use or harm while the medication is in the control of the patient, health care professional, or consumer.The overuse, underuse or misuse of medicines harms people and wastes resources.

This review will consider studies that include older adults (65 years of age and older), regardless of gender, race, or ethnicity, living in the community.

This review will consider studies that evaluate medication reconciliation strategies compared to usual care.

Usual care

none

Primary outcomes

This review will consider studies that include outcome measures of medication errors including but not limited to errors related to prescribing, labelling, dispensing, medication administration, and medication reconsolidation.

Secondary outcomes

None.

Data will be extracted from studies included in the review by two independent reviewers using the standardised data extraction tool from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument JBI-MAStARI The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives. Any disagreement that arises between the reviewers will be resolved through discussion or with a third reviewer.

Papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardised critical appraisal instruments from JBI-MAStARI. Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. For any Randomised Control Trial a YES must be answered for questions 1, 6, 7, 8, 9, and 10. For any Quasi-experimental design a YES must be answered for questions 6, 7, 8, 9, and 10. For any Comparable Cohort/ Case Control study a YES must be answered for questions 1, 3, 4, 5, 8, and 9. The decision to select these particular questions to be answered in the affirmative has been done in an attempt to achieve a consistent level of quality for studies included in this systematic review.

Quantitative data will, where possible, be pooled in statistical meta-analysis using JBI-MAStARI. All results will be subject to double data entry. Effect sizes expressed as relative risk (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals will be calculated for analysis for RCT and quasi-experimental designs. The decision to apply relative risk in this systematic review has been made as it was determined that the application of relative risk may be more acceptable to the clinician as it may present the reader with a greater ease of interpretation. Effect sizes will be expressed as relative risk for cohort studies and odds ratio for case control studies.Where statistical pooling is not possible the findings will be presented in narrative form including tables and figures to aid in data presentation where appropriate.

Heterogeneity will be assessed statistically using the standard Chi-square and also explored using subgroup analysis based on the different study designs included in this review.

If appropriate, the findings from this systematic review will inform Joanna Briggs Institute best Practice Information Sheets , Evidence Summaries and Consumer Information Sheets.

Joanna Briggs Institute Synthesis Science Unit (JBI SSU)

Synthesis Science Unit (SSU)

The Joanna Briggs Institute

Faculty of Health Sciences

The University of Adelaide

SA 5005

AUSTRALIA

jbiresearch@adelaide.edu.au

Pace University, College of Health Professions, New York, NY; New Jersey Center for Evidence Based Nursing: A Collaborating Center of the Joanna Briggs Institute at the University of Medicine and Dentistry of New Jersey

http://umdnj.edu

Ms Denise Cameli, Pace University, College of Health Professions, New York, NY.
Ms Mitzie Francis, Pace University, College of Health Professions, New York, NY.
Ms Veronica E. Francois, Pace University, College of Health Professions, New York, NY.
Ms Nia R. Medder, Pace University, College of Health Professions, New York, NY.
Ms Lorraine Von Eden, Pace University, College of Health Professions, New York, NY.
Dr Marie Truglio-Londrigan, Pace University, College of Health Professions, New York, NY; New Jersey Center for Evidence Based Nursing: A Collaborating Center of the Joanna Briggs Institute at the University of Medicine and Dentistry of New Jersey

15 August 2012

14 February 2014

Pace University, College of Health Professions, New York, NY; New Jersey Center for Evidence Based Nursing: A Collaborating Center of the Joanna Briggs Institute at the University of Medicine and Dentistry of New Jersey.

None known

The Joanna Briggs Institute PRO700

English

United States of America

Subject indexing assigned by CRD

Aged; "Continuity of Patient Care"; Humans; Medication Errors; Medication Reconciliation

21 September 2012

21 September 2012