Evidence map›Paper›PMID 26692396›Full record

ReviewDrug safety2016

Appropriate Polypharmacy and Medicine Safety: When Many is not Too Many.

Cathal A Cadogan, Cristín Ryan, Carmel M Hughes

Open access · hybridAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Drug safety, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 129 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
129citing papers in PubMed, 14 pooled it
6.6field-weighted citation impact, top 3% of its field
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

129 citing papers in PubMed, 14 syntheses or guidelines pooled it, 290 citations in OpenAlex.

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69 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 at 1 institution in 2 countries.

Cathal A CadoganSchool of Pharmacy, Queen's University Belfast, Belfast, UK. cathalcadogan@rcsi.ie.
Cristín RyanSchool of Pharmacy, Queen's University Belfast, Belfast, UK.
Carmel M HughesSchool of Pharmacy, Queen's University Belfast, Belfast, UK.
Queen's University Belfast · GB

Funding

The Dunhill Medical Trust R298/0513
6 · The paper itself

Abstract

The use of multiple medicines (polypharmacy) is increasingly common in middle-aged and older populations. Ensuring the correct balance between the prescribing of 'many' drugs and 'too many' drugs is a significant challenge. Clinicians are tasked with ensuring that patients receive the most appropriate combinations of medications based on the best available evidence, and that medication use is optimised according to patients' clinical needs (appropriate polypharmacy). Historically, polypharmacy has been viewed negatively because of the associated medication safety risks, such as drug interactions and adverse drug events. More recently, polypharmacy has been identified as a risk factor for under-prescribing, such that patients do not receive necessary medications and this can also pose risks to patients' safety and well-being. The negative connotations that have long been associated with the term polypharmacy could potentially be acting as a driving factor for under-prescribing, whereby clinicians are reluctant to prescribe necessary medicines for patients who are already receiving 'many' medicines. It is now recognised that the prescribing of 'many' medicines can be entirely appropriate in patients with several chronic conditions and that the risks of adverse drug events that have been associated with polypharmacy may be greatly reduced when patients' clinical context is taken into consideration. In this article, we outline the current perspectives on polypharmacy and make the case for adopting the term 'appropriate polypharmacy' in differentiating between the prescribing of 'many' drugs and 'too many' drugs. We also outline the inherent challenges in doing so and provide recommendations for future clinical practice and research.

Indexed as

Drug-Related Side Effects and Adverse ReactionsPolypharmacyAgedAged, 80 and overDrug InteractionsDrug PrescriptionsHumansInappropriate PrescribingMiddle AgedPatient Safety

Identifiers

PMID26692396
PMCPMC4735229
OpenAlexW2255880215

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.