Evidence map›Paper›PMID 26834959›Full record

ReviewTherapeutic advances in drug safety2016

Predicting risk of adverse drug reactions in older adults.

Amanda Hanora Lavan, Paul Gallagher

2 registry-linked trialsAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Therapeutic advances in drug safety, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 219 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
219citing papers in PubMed, 7 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
NCT04762303 naunknown statusnot on this mapstarted 2021, after this paper: background citation

Spread and Scale of a Polypharmacy App to Improve Health Outcomes of Older Adults Living in New Brunswick Nursing Homes: an Effectiveness-Implementation Hybrid Type 2 Study Design for a Stepped Wedge Cluster Randomized Trial

TypeinterventionalSponsorCentre for Innovation and Research in Aging, CanadaRan2021 to 2022Enrolled1,000ConditionsPolypharmacy, Deprescribing, Adverse Drug EventArmsMedReviewRx
3 · Its place in the literature

Who cites it

219 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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159 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

2 authors.

Amanda Hanora LavanDepartment of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland.
Paul GallagherDepartment of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Adverse drug reactions (ADRs) are common in older adults, with falls, orthostatic hypotension, delirium, renal failure, gastrointestinal and intracranial bleeding being amongst the most common clinical manifestations. ADR risk increases with age-related changes in pharmacokinetics and pharmacodynamics, increasing burden of comorbidity, polypharmacy, inappropriate prescribing and suboptimal monitoring of drugs. ADRs are a preventable cause of harm to patients and an unnecessary waste of healthcare resources. Several ADR risk tools exist but none has sufficient predictive value for clinical practice. Good clinical practice for detecting and predicting ADRs in vulnerable patients includes detailed documentation and regular review of prescribed and over-the-counter medications through standardized medication reconciliation. New medications should be prescribed cautiously with clear therapeutic goals and recognition of the impact a drug can have on multiple organ systems. Prescribers should regularly review medication efficacy and be vigilant for ADRs and their contributory risk factors. Deprescribing should occur at an individual level when drugs are no longer efficacious or beneficial or when safer alternatives exist. Inappropriate prescribing and unnecessary polypharmacy should be minimized. Comprehensive geriatric assessment and the use of explicit prescribing criteria can be useful in this regard.

Indexed as

adverse drug reactioninappropriate prescribingpolypharmacypredictive valuerisk assessment

Identifiers

PMID26834959
PMCPMC4716390

What OpenQuestion holds

Textmetadata
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.