An Overview of Systematic Reviews and Meta-Analyses on the Effect of Medication Interventions Targeting Polypharmacy for Frail Older Adults
Frailty refers to the lack of resilience and a reduction in a person’s ability to recover following a health problem, and it is increasingly becoming a challenging aspect of ageing populations. Many older adults are exposed to polypharmacy; i.e., they continue to be on medications without timely re-...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/4/1379 |
| _version_ | 1797620181891022848 |
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| author | Aparna Verma Sanjib Saha Johan Jarl Ellen Conlon Bernadette McGuinness Dominic Trépel |
| author_facet | Aparna Verma Sanjib Saha Johan Jarl Ellen Conlon Bernadette McGuinness Dominic Trépel |
| author_sort | Aparna Verma |
| collection | DOAJ |
| description | Frailty refers to the lack of resilience and a reduction in a person’s ability to recover following a health problem, and it is increasingly becoming a challenging aspect of ageing populations. Many older adults are exposed to polypharmacy; i.e., they continue to be on medications without timely re-evaluation. Medication reviews have proven successful in managing polypharmacy in the general population, but there is uncertainty regarding their effect among frail older adults. This overview of published systematic reviews assesses the impact of medication reviews on polypharmacy in frail older adults. Embase was searched from its inception to January 2021 and 28 systematic reviews were identified, out of which 10 were included in the overview. Medication reviews were the most common intervention in 8 out of 10 systematic reviews. The frailty score was reported as an outcome in one systematic review that found no evidence for fundamental pharmacological effects on frailty. Six systematic reviews reported a statistically significant reduction in the number of inappropriately prescribed medications. Four systematic reviews reported on hospital admissions, with two of them reporting a decrease in hospitalisations. The quality assessment was moderate in six and critically low in four of the systematic reviews. We conclude that medication reviews help in reducing the use of inappropriate medications in frail older adults, but that there is insufficient evidence in terms of frailty score and hospital admissions. |
| first_indexed | 2024-03-11T08:38:28Z |
| format | Article |
| id | doaj.art-29bbd8ad5ab44ace98b416fa8f9f9b94 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T08:38:28Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-29bbd8ad5ab44ace98b416fa8f9f9b942023-11-16T21:18:44ZengMDPI AGJournal of Clinical Medicine2077-03832023-02-01124137910.3390/jcm12041379An Overview of Systematic Reviews and Meta-Analyses on the Effect of Medication Interventions Targeting Polypharmacy for Frail Older AdultsAparna Verma0Sanjib Saha1Johan Jarl2Ellen Conlon3Bernadette McGuinness4Dominic Trépel5Health Economics Unit, Department of Clinical Science (Malmö), Lund University, SE-22381 Lund, SwedenHealth Economics Unit, Department of Clinical Science (Malmö), Lund University, SE-22381 Lund, SwedenHealth Economics Unit, Department of Clinical Science (Malmö), Lund University, SE-22381 Lund, SwedenTrinity College Institute for Neuroscience, Trinity College Dublin, D02 PN40 Dublin, IrelandCentre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UKTrinity College Institute for Neuroscience, Trinity College Dublin, D02 PN40 Dublin, IrelandFrailty refers to the lack of resilience and a reduction in a person’s ability to recover following a health problem, and it is increasingly becoming a challenging aspect of ageing populations. Many older adults are exposed to polypharmacy; i.e., they continue to be on medications without timely re-evaluation. Medication reviews have proven successful in managing polypharmacy in the general population, but there is uncertainty regarding their effect among frail older adults. This overview of published systematic reviews assesses the impact of medication reviews on polypharmacy in frail older adults. Embase was searched from its inception to January 2021 and 28 systematic reviews were identified, out of which 10 were included in the overview. Medication reviews were the most common intervention in 8 out of 10 systematic reviews. The frailty score was reported as an outcome in one systematic review that found no evidence for fundamental pharmacological effects on frailty. Six systematic reviews reported a statistically significant reduction in the number of inappropriately prescribed medications. Four systematic reviews reported on hospital admissions, with two of them reporting a decrease in hospitalisations. The quality assessment was moderate in six and critically low in four of the systematic reviews. We conclude that medication reviews help in reducing the use of inappropriate medications in frail older adults, but that there is insufficient evidence in terms of frailty score and hospital admissions.https://www.mdpi.com/2077-0383/12/4/1379frailtypolypharmacymedication interventions |
| spellingShingle | Aparna Verma Sanjib Saha Johan Jarl Ellen Conlon Bernadette McGuinness Dominic Trépel An Overview of Systematic Reviews and Meta-Analyses on the Effect of Medication Interventions Targeting Polypharmacy for Frail Older Adults Journal of Clinical Medicine frailty polypharmacy medication interventions |
| title | An Overview of Systematic Reviews and Meta-Analyses on the Effect of Medication Interventions Targeting Polypharmacy for Frail Older Adults |
| title_full | An Overview of Systematic Reviews and Meta-Analyses on the Effect of Medication Interventions Targeting Polypharmacy for Frail Older Adults |
| title_fullStr | An Overview of Systematic Reviews and Meta-Analyses on the Effect of Medication Interventions Targeting Polypharmacy for Frail Older Adults |
| title_full_unstemmed | An Overview of Systematic Reviews and Meta-Analyses on the Effect of Medication Interventions Targeting Polypharmacy for Frail Older Adults |
| title_short | An Overview of Systematic Reviews and Meta-Analyses on the Effect of Medication Interventions Targeting Polypharmacy for Frail Older Adults |
| title_sort | overview of systematic reviews and meta analyses on the effect of medication interventions targeting polypharmacy for frail older adults |
| topic | frailty polypharmacy medication interventions |
| url | https://www.mdpi.com/2077-0383/12/4/1379 |
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