Evidence map›Paper›PMID 25516023›Full record

SynthesisJournal of the American Geriatrics Society2014

Health outcomes associated with polypharmacy in community-dwelling older adults: a systematic review.

Terri R Fried, John O'Leary, Virginia Towle, Mary K Goldstein, Mark Trentalange, Deanna K Martin

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the American Geriatrics Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03903484 (A Collaborative Intervention for Streamlining Medication Appropriateness and Deprescribing Within Integrated Health-Care Teams), which is not on this map. Cited by 345 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
345citing papers in PubMed, 15 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.

NCT03903484 nacompletednot on this mapstarted 2019, after this paper: background citation

A Collaborative Intervention for Streamlining Medication Appropriateness and Deprescribing Within Integrated Health-Care Teams

TypeinterventionalSponsorNova Scotia Health AuthorityRan2019 to 2022Enrolled7ConditionsInappropriate Prescribing, Primary Health Care, PolypharmacyArmsDeprescribing toolbox and intervention
3 · Its place in the literature

Who cites it

345 citing papers in PubMed, 15 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Pooled it
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

285 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

6 authors.

Terri R FriedClinical Epidemiology Research Center, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut; Department of Medicine, Yale University.
John O'Leary
Virginia Towle
Mary K Goldstein
Mark Trentalange
Deanna K Martin

Funding

Yale Study Support Suite (YES3): Dashboard and Web Portal Software Supporting Research Workflow through integrated, customizable REDCap External ModulesP30AG021342 · NIA · YALE UNIVERSITY · PI Albert C Shaw · 2002 to 2026
$37.9M
NIA NIH HHS P30 AG021342NIA NIH HHS P30AG21342
6 · The paper itself

Abstract

objectivesTo summarize evidence regarding the health outcomes associated with polypharmacy, defined as number of prescribed medications, in older community-dwelling persons.

designSystematic review of MEDLINE (OvidSP 1946 to May, Week 3, 2014).

settingCommunity.

participantsObservational studies examining health outcomes according to number of prescription medications taken. MEASUREMENTS: Association between number of medications and health outcomes. Because of the importance of comorbidity as a potential confounder of the relationship between polypharmacy and health outcomes, articles were assessed regarding the quality of their adjustment for confounding.

resultsOf the 50 studies identified, the majority that were rated good in terms of their adjustment for comorbidity demonstrated relationships between polypharmacy and a range of outcomes, including falls, fall outcomes, fall risk factors, adverse drug events, hospitalization, mortality, and measures of function and cognition. However, a number of these studies failed to demonstrate associations, as did a substantial proportion of studies rated fair or poor.

conclusionData are mixed regarding the relationship between polypharmacy, considered in terms of number of medications, and adverse outcomes in community-dwelling older persons. Because of the challenge of confounding, randomized controlled trials of medication discontinuation may provide more-definitive evidence regarding this relationship than observational studies can provide.

Indexed as

PolypharmacyAccidental FallsAgedAged, 80 and overChronic DiseaseComorbidityDrug-Related Side Effects and Adverse ReactionsGeriatric AssessmentHumansPrescription DrugsRisk FactorsPrescription Drugsobservational studiespolypharmacysystematic review

Identifiers

PMID25516023
PMCPMC4270076

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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.