title: The effect of pharmacist-led interventions in optimising prescribing in older adults in primary care: A systematic review.
abstract: OBJECTIVE
  To evaluate studies of pharmacist-led interventions on potentially inappropriate prescribing among community-dwelling older adults receiving primary care to identify the components of a successful intervention.
  
  
  METHODS
  An electronic search of the literature was conducted using the following databases from inception to December 2015: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, MEDLINE (through Ovid), Trip, Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews, ISI Web of Science, ScienceDirect, ClinicalTrials.gov, metaRegister of Controlled Trials, ProQuest Dissertations & Theses Database (Theses in Great Britain, Ireland and North America).
  
  
  METHODS
  Studies were included if they were randomised controlled trials or quasi-randomised studies involving a pharmacist-led intervention compared to usual/routine care which aimed to reduce potentially inappropriate prescribing in older adults in primary care. Methodological quality of the included studies was independently assessed.
  
  
  RESULTS
  A comprehensive literature search was conducted which identified 2193 studies following removal of duplicates. Five studies met the inclusion criteria. Four studies involved a pharmacist conducting a medication review and providing feedback to patients or their family physician. One randomised controlled trial evaluated the effect of a computerised tool that alerted pharmacists when elderly patients were newly prescribed potentially inappropriate medications. Four studies were associated with an improvement in prescribing appropriateness.
  
  
  CONCLUSIONS
  Overall, this review demonstrates that pharmacist-led interventions may improve prescribing appropriateness in community-dwelling older adults. However, the quality of evidence is low. The role of a pharmacist working as part of a multidisciplinary primary care team requires further investigation to optimise prescribing in this group of patients.
authors.affiliation: Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Republic of Ireland.
authors.forename: David O
authors.initials: DO
authors.lastname: Riordan
authors.affiliation: Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Republic of Ireland.
authors.forename: Kieran A
authors.initials: KA
authors.lastname: Walsh
authors.affiliation: Department of Clinical Therapies, Health Research Institute, University of Limerick, Limerick, Republic of Ireland.
authors.forename: Rose
authors.initials: R
authors.lastname: Galvin
authors.affiliation: Department of General Practice, University College Cork, Cork, Republic of Ireland.
authors.forename: Carol
authors.initials: C
authors.lastname: Sinnott
authors.affiliation: Department of Epidemiology and Public Health, University College Cork, Cork, Republic of Ireland.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Kearney
authors.affiliation: Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Republic of Ireland.
authors.forename: Stephen
authors.initials: S
authors.lastname: Byrne
keywords: Pharmacist interventions; older people; prescribing; primary care; systematic review