Does home based medication review keep older people out of hospital? The HOMER randomised controlled trial

A possible adverse effect of pharmacy review of older peoples'
medications is an inappropriate medical response to the identification of
possible drug interactions. In many cases the appropriate response is
either to continue the prescription having assessed that the risk of harm
from the interaction is less than the likely benefit of continuing the
drug(s); or to ensure that the relevant drug doses are titrated to
mitigate the ill-effects of the interaction. If many of the doctors
treating the study patients were unused to responding to pharmacy reviews,
there could have been a tendency to withdraw beneficial drugs when
possible interactions or other side-effects were identified.

If this adverse effect did occur, one would expect it to become
smaller as the local doctors acquired more experience of assessing
pharmacist-initiated referrals.

Competing interests:
None declared