Eighteen studies (reported in 19 articles) were included in the review: 1 quasi-experimental study, 1 observational cohort study, 7 observational-cross-sectional studies, 4 observational before-and-after studies and 5 observational case series. The number of patients was not reported.
Fourteen studies were from the UK, two from the USA, one from Canada and one from New Zealand.
Patient benefits and risks.
Studies reported the following benefits from the use of interventions: evidence of a decrease in wastage of POMs either from preventing their loss or avoiding their destruction by the hospital pharmacy (7 studies); improved accuracy of admission orders (3 studies); removal of unsuitable or unneeded POMs (5 studies); additional opportunities for patient counselling and direct patient care (4 studies); and an increase in identification of prescribing errors when a pharmacist conducted medial histories compared with a pharmacist reviewing admission orders (1 study). One study found no significant differences in medication administration errors found by a nurse when POMs were used compared with traditional hospital pharmacy-dispensed prescriptions.
Hospital benefits and risks.
No studies reported evidence that POM use increased legal risks to the hospital, although this was assessed in only 3 studies.
Impact on health care providers.
Ten studies assessed the pharmacist conducting patient interviews and/or evaluating POMs for use by patients either during administration or upon discharge. Other health professionals that evaluated POMs were nurses (2 studies) and pharmacy technicians (2 studies). The mean time to conduct a medication history (assessed by 3 studies) ranged from 10 to 20 minutes per patient. One study reported that after a review of patient's medication history by a pharmacist, each clinical intervention to alter drug therapy took on average 18 minutes.