Evidence map›Paper›PMID 22965651›Full record

ReviewEuropean journal of clinical pharmacology2013

Medication prescribing in frail older people.

Ruth E Hubbard, M Sinead O'Mahony, Kenneth W Woodhouse

Abstract readReview
PubMed Publisher
In one paragraph

Review in European journal of clinical pharmacology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
85citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

85 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Efficacy and Safety of Dapagliflozin in Patients With Chronic Kidney Disease Across the Spectrum of Frailty.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024
    Trial
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  7. Article
  8. Review
  9. Article
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  15. Review
  16. Article
  17. Application of Claims-based Frailty Index to a Structured Electronic Health Record Data.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025
    Article
  18. Finerenone and Clinical Outcomes in CKD and Type 2 Diabetes by Frailty Index: FIDELITY Post Hoc Analysis.Clinical journal of the American Society of Nephrology : CJASN · 2025
    Article
  19. Article
  20. Factors Affecting Medication Adherence in Middle-Aged and Elderly Patients in China: A Cross-Sectional Study.Medical science monitor : international medical journal of experimental and clinical research · 2025
    Article

25 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Ruth E HubbardCentre for Research in Geriatric Medicine, School of Medicine, Princess Alexandra Hospital/The University of Queensland, Woolloongabba, Brisbane, Queensland 4102, Australia. r.hubbard1@uq.edu.au
M Sinead O'Mahony
Kenneth W Woodhouse

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWhile some people remain fit and active as they grow older, others experience complex problems: disease, dependency and disability. Frailty is a term used to describe this latter group, capturing differences in health status among older people. Many frail older people have multiple chronic co-morbidities and functional impairments and, according to guidelines for the management of individual conditions, should be prescribed long lists of medications. However, older people (particularly those who are frail) are often excluded from drug trials, and treatment decisions are therefore based on evidence extrapolated from more robust patient groups with fewer physiological deficits. The risk of adverse drug reactions (ADRs) increases with increasing patient frailty, and polypharmacy has negative consequences above and beyond the risks of individual drugs. Increasing numbers of medications are associated with a higher likelihood of non-adherence and a significantly greater risk of ADRs. Older people taking five or more medications are at higher risk of delirium and falls, independent of medication indications.

methodsThis is a short review of the different approaches to defining and measuring frailty. We summarise the factors contributing to ADRs in frail older people and describe the pharmacokinetic and pharmacodynamics changes associated with ageing and frailty. By considering goals of care for frail older people, we explore how the appropriateness of medication prescribing for older people could be improved.

conclusionSince all physicians are likely to provide care for this group of vulnerable patients, understanding the concept of frailty may help to optimise medication prescribing for older people. The incorporation of frailty measures into future clinical studies of drug effects and pharmacokinetics is important if we are to improve medication use and guide drug doses for fit and frail older people.

Indexed as

AgingDrug PrescriptionsFrail ElderlyPractice Patterns, Physicians'Accidental FallsAgedAged, 80 and overAge FactorsComorbidityDeliriumDrug InteractionsGeriatric AssessmentHumansInappropriate PrescribingMedication AdherencePatient SelectionPrescription Drugs

Identifiers

PMID22965651

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.