Evidence map›Paper›PMID 26668713›Full record

ReviewTherapeutic advances in drug safety2015

Routine deprescribing of chronic medications to combat polypharmacy.

Doron Garfinkel, Birkan Ilhan, Gulistan Bahat

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

Review in Therapeutic advances in drug safety, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03689049 (SPIDER), which is not on this map. Cited by 52 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing 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.

NCT03689049 naactive not recruitingnot on this mapstarted 2018, after this paper: background citation

SPIDER: A Structured Process Informed by Data, Evidence and Research - A Research and Quality Improvement Collaboration Supporting Practices in Improving Care for Complex Elderly Patients

TypeinterventionalSponsorUniversity of Toronto Practice Based Research NetworkRan2018 to 2027Enrolled104ConditionsPolypharmacy, Inappropriate Prescribing, Aged, Primary Health CareArmsSPIDER, Usual Care
3 · Its place in the literature

Who cites it

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

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  17. Perspectives on deprescribing in palliative care.Expert review of clinical pharmacology · 2023
    Review
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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.

Doron GarfinkelHome Care Hospice, Israel Cancer Association, 55 Ben Gurion Road, Bat, Yam, Israel 5932210.
Birkan IlhanDepartment of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul Medical School, Istanbul, Turkey.
Gulistan BahatDepartment of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul Medical School, Istanbul, Turkey.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The positive benefit-risk ratio of most drugs is decreasing in correlation to very old age, the extent of comorbidity, dementia, frailty and limited life expectancy (VOCODFLEX). First, we review the extent of inappropriate medication use and polypharmacy (IMUP) globally and highlight its negative medical, nursing, social and economic consequences. Second, we expose the main clinical/practical and perceptual obstacles that combine to create the negative vicious circle that eventually makes us feel frustrated and hopeless in treating VOCODFLEX in general, and in our 'war against IMUP' in particular. Third, we summarize the main international approaches/methods suggested and tried in different countries in an attempt to improve the ominous clinical and economic outcomes of IMUP; these include a variety of clinical, pharmacological, computer-assisted and educational programs. Lastly, we suggest a new comprehensive perception for providing good medical practice to VOCODFLEX in the 21st century. This includes new principles for research, education and clinical practice guidelines completely different from the 'single disease model' research and clinical rules we were raised upon and somehow 'fanatically' adopted in the 20th century. This new perception, based on palliative, geriatric and ethical principle, may provide fresh tools for treating VOCODFLEX in general and reducing IMUP in particular.

Indexed as

ComorbidityDementiaFrailtyGeriatric-PalliativeIGRIMUPInappropriate-Medication-UseLimited Life-expectancyPolypharmacy

Identifiers

PMID26668713
PMCPMC4667766

What OpenQuestion holds

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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.