***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background To improve continuity of care at hospital admission and discharge and to decrease medication errors pharmaceutical care programs are developed . This study aims to determine the cost-effectiveness of the COACH program in comparison with usual care from a societal perspective . Methods A controlled clinical trial was performed at the Internal Medicine department of a general teaching hospital . All admitted patients using at least one prescription drug were included .  The COACH program consisted of medication reconciliation , patient counselling at discharge , and communication to healthcare providers in primary care . The primary outcome was the proportion of patients with an unplanned rehospitalisation within three months after discharge . Also , the number of quality -adjusted life-years ( QALYs ) was assessed . Cost data were collected using cost diaries . Uncertainty surrounding cost differences and incremental cost-effectiveness ratios between the groups was estimated by bootstrapping . Results In the COACH program , 168 patients were included and in usual care 151 patients . There was no significant difference in the proportion of patients with unplanned rehospitalisations ( mean difference 0.17 % , 95 % CI -8.85;8.51 ) , and in QALYs ( mean difference -0.0085 , 95 % CI -0.0170;0.0001 ) . Total costs for the COACH program were non-significantly lower than usual care ( -€1160 , 95 % CI -3168;847 ) . Cost-effectiveness planes showed that the program was not cost-effective compared with usual care for unplanned rehospitalisations and QALYs gained . Conclusion The COACH program was not cost-effective in comparison with usual care . Future studies should focus on high risk patients and include other outcomes ( e.g. adverse drug events ) as this may increase the chances of a cost-effective intervention . Dutch trial register & NA ; A critical analysis of the research on clinical pharmacy services with regards to study characteristics has not been undertaken since 1998 . However , several meta‐analyses have been conducted to demonstrate the impact of  pharmacists ' interventions in specific medical conditions . These meta‐analyses present high heterogeneity in part because the interventions are poorly and inconsistently described in primary studies . The aim of this article is to present the characteristics of r and omized control trials ( RCTs ) that assess clinical pharmacy services to identify areas of improvement in future pharmacy practice research studies . Different emphasis of research across geographic regions of the world were also examined . During these 40 years , 520 articles reporting 439 RCTs assessing clinical pharmacy services were published . Of the 439 studies , 77.7 % ( n = 341 ) were published in the year 2000 or thereafter , 41.46 % ( n = 182 ) were conducted in the US , 27.56 % ( n = 121 ) in Europe , and 30.98 % ( n = 136 ) in the rest of the world . Studies in pharmacy practice have improved in terms of design , with an increase in the number of published RCTs after 2000 . However , the small sample size of RCTs is still an issue . After 2000 , a significantly higher proportion of studies were conducted in community pharmacy , targeting specific medical conditions , and with a higher number of patients  r and omized to the intervention group . Conversely , a significantly smaller proportion of studies were conducted in the hospital and targeted a single recipient after 2000 . Studies conducted in the US had significantly more intervention arms , focused mostly on a specific medical condition , and were performed in primary care . Different health care systems ' organization and policies may influence clinical pharmacy services research across countries OBJECTIVES to investigate the effectiveness of a  pharmacy discharge plan  in elderly hospitalized patients . DESIGN r and omized controlled trial . SUBJECTS AND SETTING S we r and omized patients aged 75 years and older on four or more medicines who had been discharged from three acute general and one long-stay hospital to a pharmacy intervention or usual care . INTERVENTIONS the hospital pharmacist developed discharge plans which gave details of medication and support required by the patient . A copy was given to the patient and to all relevant professionals and carers . This was followed by a domiciliary assessment by a community pharmacist . In the control group , patients were discharged from hospital following st and ard procedures that included a discharge letter to the general practitioner listing current medications . OUTCOMES the primary outcome was re-admission to hospital within 6 months . Secondary outcomes included the number of deaths , attendance at hospital outpatient clinics and general practice and proportion of days in hospital over the follow-up period , together with patients ' general well-being , satisfaction with the service and knowledge of and adherence to prescribed medication . RESULTS we recruited 362 patients , of whom 181 were r and omized to each group . We collected hospital and general practice data on at least 91 and 72 % of patients respectively at each follow-up point and interviewed between 43 and 90 % of the study subjects . There were no significant differences between the groups in the proportion of patients re-admitted to hospital between baseline and 3 months or 3 and 6 months . There were no significant differences in any of the secondary outcomes . CONCLUSIONS we found no evidence to suggest that the co-ordinated hospital and community pharmacy care discharge plans in elderly patients in this study influence outcomes BACKGROUND Hospitalization and subsequent discharge home often involve discontinuity of care , multiple changes in medication regimens , and inadequate patient education , which can lead to adverse drug events ( ADEs ) and avoidable health care utilization . Our objectives were to identify drug-related problems during and after hospitalization and to determine the effect of patient counseling and follow-up by pharmacists on preventable ADEs . METHODS We conducted a r and omized trial of 178 patients being discharged home from the general medicine service at a large teaching hospital . Patients in the intervention group received pharmacist counseling at discharge and a follow-up telephone call 3 to 5 days later . Interventions focused on clarifying medication regimens ; review ing indications , directions , and potential side effects of medications ; screening for barriers to adherence and early side effects ; and providing patient counseling and /or physician feedback when appropriate . The primary outcome was rate of preventable ADEs . RESULTS Pharmacists observed the following drug-related problems in the intervention group : unexplained discrepancies between patients ' preadmission medication regimens and discharge medication orders in 49 % of patients , unexplained discrepancies between discharge medication lists and postdischarge regimens in 29 % of patients , and medication nonadherence in 23 % . Comparing trial outcomes 30 days after discharge , preventable ADEs were detected in 11 % of patients in the control group and 1 % of patients in the intervention group ( P = .01 ) . No differences were found between groups in total ADEs or total health care utilization . CONCLUSIONS Pharmacist medication review , patient counseling , and telephone follow-up were associated with a lower rate of preventable ADEs 30 days after hospital discharge . Medication discrepancies before and after discharge were common targets of intervention OBJECTIVES : This study aim ed to evaluate the impact of pharmacist-provided discharge counseling on mortality rate , hospital readmissions , emergency department visits , and medication adherence at 30 days post discharge . METHODS : This r and omized controlled trial was approved by the local ethics committee and included patients aged 18 years or older admitted to the cardiology ward of a Brazilian tertiary hospital . The intervention group received a pharmacist-led medication counseling session at discharge and a telephone follow-up three and 15 days after discharge . The outcomes included the number of deaths , hospital readmissions , emergency department visits , and medication adherence . All outcomes were evaluated during a pharmacist-led ambulatory consultation performed 30 days after discharge . RESULTS : Of 133 patients , 104 were included in the analysis ( 51 and 53 in the intervention and control groups , respectively ) . The intervention group had a lower overall readmission rate , number of emergency department visits , and mortality rate , but the differences were not statistically significant ( p>0.05 ) . However , the intervention group had a significantly lower readmission rate related to heart disease ( 0 % vs. 11.3 % , p=0.027 ) , despite the small sample size . Furthermore , medication counseling contributed significantly to improved medication adherence according to three different tools ( p<0.05 ) . CONCLUSIONS : Pharmacist-provided discharge medication counseling result ed in better medication adherence scores and a lower incidence of cardiovascular-associated hospital readmissions , thus representing a useful service for cardiology patients Importance Hospital readmissions are common among patients receiving multiple medications , with considerable costs to the patients and society . Objective To determine whether a multifaceted pharmacist intervention based on medication review , patient interview , and follow-up can reduce the number of readmissions and emergency department ( ED ) visits . Design , Setting , and Participants This r and omized clinical multicenter study ( Odense Pharmacist Trial Investigating Medication Interventions at Sector Transfer [ OPTIMIST ] ) enrolled patients from September 1 , 2013 , through April 23 , 2015 , with a follow-up of 6 months completed on October 31 , 2015 . Consecutive medical patients in an acute admission ward who were 18 years or older and who used 5 or more medications were invited to participate . Of 1873 patients invited to participate , 1499 ( 80.0 % ) accepted . The medication review and patient interview were conducted in the hospital and followed up in collaboration with primary care . Analysis was based on intention to treat . Interventions The patients were r and omized into 3 groups receiving usual care ( no intervention ) , a basic intervention ( medication review ) , and an extended intervention ( medication review , 3 motivational interviews , and follow-up with the primary care physician , pharmacy , and nursing home ) . Main Outcomes and Measures The prespecified primary outcomes were readmission within 30 or 180 days and ED visits within 180 days . The primary composite end point was readmission or an ED visit within 180 days . Secondary outcomes were drug-related readmissions within 30 and 180 days after inclusion , and all-cause mortality and drug-related mortality . Results A total of 1467 patients ( 679 men [ 46.3 % ] and 788 women [ 53.7 % ] ; median age , 72 years ; interquartile range , 63 - 80 years ) were part of the primary analysis , including 498 r and omized to usual care , 493 r and omized to the basic intervention , and 476 r and omized to the extended intervention . The extended intervention had a significant effect on the numbers of patients who were readmitted within 30 days ( hazard ratio [ HR ] , 0.62 ; 95 % CI , 0.46 - 0.84 ) or within 180 days ( HR , 0.75 ; 95 % CI , 0.62 - 0.90 ) after inclusion and on the number of patients who experienced the primary composite end point ( HR , 0.77 ; 95 % CI , 0.64 - 0.93 ) . The study showed a nonsignificant reduction in drug-related readmissions within 30 days ( HR , 0.65 ; 95 % CI , 0.39 - 1.09 ) and within 180 days ( HR , 0.80 ; 95 % CI , 0.59 - 1.08 ) after inclusion and in deaths ( HR , 0.83 ; 95 % CI , 0.22 - 3.11 ) . The number needed to treat to achieve the primary composite outcome for the extended intervention ( vs usual care ) was 12 . Conclusions and Relevance A multifaceted clinical pharmacist intervention may reduce the number of ED visits and hospital readmissions . Trial Registration clinical trials.gov Identifier : Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the 
    Output:
    
Insufficient evidence exists regarding the effect of pharmacist-led discharge counseling on hospital readmission and emergency department visits .