***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: Introduction : Care home residents are at particular risk from medication errors , and our objective was to determine the prevalence and potential harm of prescribing , monitoring , dispensing and administration errors in UK care homes , and to identify their causes . Methods : A prospect i ve study of a r and om sample of residents within a purposive sample of homes in three areas . Errors were identified by patient interview , note review , observation of practice and examination of dispensed items . Causes were understood by observation and from theoretically framed interviews with home staff , doctors and pharmacists . Potential harm from errors was assessed by expert judgement . Results : The 256 residents recruited in 55 homes were taking a mean of 8.0 medicines . One hundred and seventy-eight ( 69.5 % ) of residents had one or more errors . The mean number per resident was 1.9 errors . The mean potential harm from prescribing , monitoring , administration and dispensing errors was 2.6 , 3.7 , 2.1 and 2.0 ( 0 = no harm , 10 = death ) , respectively . Contributing factors from the 89 interviews included doctors who were not accessible , did not know the residents and lacked information in homes when prescribing ; home staff ’s high workload , lack of medicines training and drug round interruptions ; lack of team work among home , practice and pharmacy ; inefficient ordering systems ; inaccurate medicine records and prevalence of verbal communication ; and difficult to fill ( and check ) medication administration systems . Conclusions : That two thirds of residents were exposed to one or more medication errors is of concern . The will to improve exists , but there is a lack of overall responsibility . Action is required from all concerned Objectives To compare the effectiveness of pharmacist medication review , with or without pharmacist prescribing , with st and ard care , for patients with chronic pain . Design An exploratory r and omised controlled trial . Setting Six general practice s with prescribing pharmacists in Grampian ( 3 ) and East Anglia ( 3 ) . Participants Patients on repeat prescribed pain medication ( 4815 ) were screened by general practitioners ( GPs ) , and mailed invitations ( 1397 ) . 196 were r and omised and 180 ( 92 % ) completed . Exclusion criteria included : severe mental illness , terminally ill , cancer related pain , history of addiction . R and omisation and intervention Patients were r and omised using a remote telephone service to : ( 1 ) pharmacist medication review with face-to-face pharmacist prescribing ; ( 2 ) pharmacist medication review with feedback to GP and no planned patient contact or ( 3 ) treatment as usual ( TAU ) . Blinding was not possible . Outcome measures Outcomes were the SF-12v2 , the Chronic Pain Grade ( CPG ) , the Health Utilities Index 3 and the Hospital Anxiety and Depression Scale ( HADS ) . Outcomes were collected at 0 , 3 and 6 months . Results In the prescribing arm ( n=70 ) two patients were excluded/nine withdrew . In the review arm ( n=63 ) one was excluded/three withdrew . In the TAU arm ( n=63 ) four withdrew . Compared with baseline , patients had an improved CPG in the prescribing arm , 47.7 % ( 21/44 ; p=0.003 ) and in the review arm , 38.6 % ( 17/44 ; p=0.001 ) , but not the TAU group , 31.3 % ( 15/48 ; ns ) . The SF-12 Physical Component Score showed no effect in the prescribing or review arms but improvement in TAU ( p=0.02 ) . The SF-12 Mental Component Score showed no effect for the prescribing or review arms and deterioration in the TAU arm ( p=0.002 ) . HADS scores improved within the prescribing arm for depression ( p=0.022 ) and anxiety ( p=0.007 ) , between groups ( p=0.022 and p=0.045 , respectively ) . Conclusions This is the first r and omised controlled trial of pharmacist prescribing in the UK , and suggests that there may be a benefit for patients with chronic pain . A larger trial is required . Trial registration : www.is rct n.org/IS RCT N06131530 . Medical Research Council funding OBJECTIVES To assess the effect of a Screening Tool of Older Persons potentially inappropriate Prescriptions/Screening Tool to Alert doctors to Right Treatment ( STOPP/START ) medication intervention on clinical and economic outcomes . DESIGN Parallel-group r and omized trial . SETTING Chronic care geriatric facility . PARTICIPANTS Residents aged 65 and older prescribed with at least one medication ( N = 359 ) were r and omized to receive usual pharmaceutical care or undergo medication intervention . INTERVENTION Screening medications with STOPP/START criteria followed up with recommendations to the chief physician . MEASUREMENTS The outcome measures assessed at the initiation of the intervention and 1 year later were number of hospitalizations and falls , Functional Independence Measure ( FIM ) , quality of life ( measured using the Medical Outcomes Study 12-item Short-Form Health Survey ) , and costs of medications . RESULTS The average number of drugs prescribed was significantly lower in the intervention than in the control group after 1 year ( P < .001 ) . The average drug costs in the intervention group decreased by 103 shekels ( US$ 29 ) per participant per month ( P < .001 ) . The average number of falls in the intervention group dropped significantly ( P = .006 ) . Rates of hospitalization , FIM scores , and quality of life measurements were similar for both groups . CONCLUSION Implementation of STOPP/START criteria reduced the number of medications , falls , and costs in a geriatric facility . Their incorporation in those and similar setting s is recommended OBJECTIVES Evaluate whether implementing of pharmacy-led psychopharmacology rounds in a nursing facility will improve the rate of antipsychotic use . DESIGN Single-center , prospect i ve ; medication use evaluation ( MUE ) . SETTING Rutl and Nursing Home , Brooklyn , New York . PARTICIPANTS Nursing facility residents , excluding the pediatric unit . INTERVENTIONS Weekly interdisciplinary psychopharmacology rounds that include : clinical pharmacists , nurse managers , medical director , social workers , and administration . Antipsychotics were analyzed for all residents for appropriateness of use , proper documentation , and adequate monitoring . MAIN OUTCOME MEASURE Assess the overall rate of reduction of antipsychotic use after implementation of psychopharmacology rounds . Secondary outcomes assessed improvements in monitoring and documentation for residents on antipsychotics . RESULTS A total of 81 residents were evaluated over the six-month MUE . Of those residents , 20 had their antipsychotics discontinued , and 11 had their antipsychotics tapered . The overall use of antipsychotics decreased from 14.6 % ( 62/422 ) to 12.2 % ( 50/411 ) ( P = 0.285 ) . Compliance with indications generally approved by the Centers for Medicare & Medicaid Services improved from 65 % ( 37/57 ) to 85 % ( 46/54 ) ( P = 0.008 ) . Matching indications on the psychiatry consult and the medication order improved from 58 % ( 33/57 ) to 80 % ( 43/54 ) ( P = 0.015 ) . Metabolic laboratory monitoring improved from 58 % ( 33/57 ) to 83 % ( 45/54 ) ( P = 0.003 ) . Improvements in timeliness of psychiatry and ophthalmology consults were not statistically significant . CONCLUSION Implementing interdisciplinary psycho-pharmacology rounds in a nursing facility result ed in a reduction of inappropriate antipsychotic use and improved monitoring and documentation AIMS To evaluate whether a year long clinical pharmacy program involving development of professional relationships , nurse education on medication issues , and individualized medication review s could change drug use , mortality and morbidity in nursing home residents . METHODS A cluster r and omised controlled trial , where an intervention home was matched to three control homes , was used to examine the effect of the clinical pharmacy intervention on resident outcomes . The study involved 905 residents in 13 intervention nursing homes and 2325 residents in 39 control nursing homes in south-east Queensl and and north-east New South Wales , Australia . The outcome measures were : continuous drug use data from government prescription subsidy cl aims , cross-sectional drug use data on prescribed and administered medications , deaths and morbidity indices ( hospitalization rates , adverse events and disability indices ) . RESULTS This intervention result ed in a reduction in drug use with no change in morbidity indices or survival . Differences in nursing home characteristics , as defined by cluster analysis with SUDAAN , negated intervention-related apparent significant improvements in survival . The use of benzodiazepines , nonsteroidal anti-inflammatory drugs , laxatives , histamine H2-receptor antagonists and antacids  was significantly reduced in the intervention group , whereas the use of digoxin and diuretics remained similar to controls . Overall , drug use in the intervention group was reduced by 14.8 % relative to the controls , equivalent to an annual prescription saving of A64 dollars per resident ( approximately 25 pound sterling ) . CONCLUSIONS This intervention improved nursing home resident outcomes related to changes in drug use and drug-related expenditure . The continuing divergence in both drug use and survival at the end of the study suggests that the difference would have been more significant in a larger and longer study , and even more so using additional instruments specific for measuring outcomes related to changes in drug use OBJECTIVE to measure the impact of pharmacist-conducted clinical medication review with elderly care home residents . DESIGN r and omised controlled trial of clinical medication review by a pharmacist against usual care . SETTING sixty-five care homes for the elderly in Leeds , UK . PARTICIPANTS a total of 661 residents aged 65 + years on one or more medicines . INTERVENTION clinical medication review by a pharmacist with patient and clinical records . Recommendations to general practitioner for approval and implementation . Control patients received usual general practitioner care . MAIN OUTCOME MEASURES primary : number of changes in medication per participant . Secondary : number and cost of repeat medicines per participant ; medication review rate ; mortality , falls , hospital admissions , general practitioner consultations , Barthel index , St and ardised Mini-Mental State Examination ( SMMSE ) . RESULTS the pharmacist review ed 315/331 ( 95.2 % ) patients in 6 months . A total of 62/330 ( 18.8 % ) control patients were review ed by their general practitioner . The mean number of drug changes per patient were 3.1 for intervention and 2.4 for control group ( P < 0.0001 ) . There were respectively 0.8 and 1.3 falls per patient ( P < 0.0001 ) . There was no significant difference for GP consultations per patient ( means 2.9 and 2.8 in 6 months , P = 0.5 ) , hospitalisations ( means 0.2 and 0.3 , P = 0.11 ) , deaths ( 51/331 and 48/330 , P = 0.81 ) , Barthel score ( 9.8 and 9.3 , P = 0.06 ) , SMMSE score ( 13.9 and 13.8 , P = 0.62 ) , number and cost of drugs per patient ( 6.7 and 6.9 , P = 0.5 ) ( pounds sterling 42.24 and pounds sterling 42.94 per 28 days ) . A total of 75.6 % ( 565/747 ) of pharmacist recommendations were accepted by the general practitioner ; and 76.6 % ( 433/565 ) of accepted recommendations were implemented . CONCLUSIONS general practitioners do not review most care home patients ' medication . A clinical pharmacist can review them and make recommendations that are usually accepted . This leads to substantial change in patients ' medication regimens without change in drug costs . There is a reduction in the number of falls . There is no significant change in consultations , hospitalisation , mortality , SMMSE or Barthel scores Aim of study : This study sought to determine whether multidisciplinary case conference review s improved outcomes for nursing home residents , and the effects of this team approach to resident care on carers , including the h and s-on carers employed by the nursing home , and health professionals . Method : 245 residents of three Canberra nursing homes were enrolled in this non-r and omised controlled trial . The intervention consisted of sessions of three case conference review s held between 10/4sol;96 and 4sol;12sol;96 . These sessions were attended by the General Practitioners ( GPs ) of the residents discussed , the GP project officer from the ACT Division of General Practice , a clinical pharmacist , senior nursing staff , other health professionals eg physiotherapist , and occasionally the resident concerned or their representative . At each review , a case presentation by the resident 's GP was followed by a multidisciplinary discussion of all aspects , medical and non-medical , of the resident 's care . The review concluded with a management plan for the resident . In total 75 residents were review ed . Main outcome measures : Medication use and cost , and mortality . Results : One month after the review s were completed comparisons between those who were review ed and those who were not showed 
    Output:
    
Provision of pharmaceutical care , effective multidisciplinary working and care home staff training represented the main areas of practical knowledge .
This study provides insight into potential codified and practical knowledge requirements for pharmacists assuming responsibility for the provision of pharmaceutical care within care homes .