Evidence map›Paper›PMID 27426227›Full record

ArticleBritish journal of clinical pharmacology2016

Too many, too few, or too unsafe? Impact of inappropriate prescribing on mortality, and hospitalization in a cohort of community-dwelling oldest old.

Maarten Wauters, Monique Elseviers, Bert Vaes, Jan Degryse, Olivia Dalleur, Robert Vander Stichele, Thierry Christiaens, Majda Azermai

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

Article in British journal of clinical pharmacology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04142645 (Pilot Study of the OptiMEDs Intervention), which is not on this map. Cited by 55 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 4 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.

NCT04142645 nacompletednot on this mapstarted 2019, after this paper: background citation

Pilot Study of the OptiMEDs Intervention: a Complex Intervention for Multidisciplinary Medication Review (Including Nurses, Pharmacists, and Physicians) in Nursing Homes, With ICT-support for the Evaluation of the Appropriateness of Prescribing and for Side-effect Monitoring

TypeinterventionalSponsorUniversity GhentRan2019 to 2020Enrolled148ConditionsMedication Review, Nursing Home Resident, Nursing HomeArmsOptiMEDs
3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  4. Ambulatory Medication Safety in Primary Care: A Systematic Review.Journal of the American Board of Family Medicine : JABFM
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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

8 authors.

Maarten WautersClinical Pharmacology Research Unit, Ghent University, Heymans Institute of Pharmacology, Ghent. maarten.wauters@ugent.be.
Monique ElseviersClinical Pharmacology Research Unit, Ghent University, Heymans Institute of Pharmacology, Ghent.
Bert VaesCliniques Universitaires Saint-Luc, Université Catholique de Louvain, Louvain Drug Research Institute, Brussels.
Jan DegryseCliniques Universitaires Saint-Luc, Université Catholique de Louvain, Louvain Drug Research Institute, Brussels.
Olivia DalleurClinical Pharmacy Research Group, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels.
Robert Vander SticheleClinical Pharmacology Research Unit, Ghent University, Heymans Institute of Pharmacology, Ghent.
Thierry ChristiaensClinical Pharmacology Research Unit, Ghent University, Heymans Institute of Pharmacology, Ghent.
Majda AzermaiClinical Pharmacology Research Unit, Ghent University, Heymans Institute of Pharmacology, Ghent.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsLittle is known about the impact of inappropriate prescribing (IP) in community-dwelling adults, aged 80 years and older. The prevalence at baseline (November 2008September 2009) and impact of IP (misuse and underuse) after 18 months on mortality and hospitalization in a cohort of community-dwelling adults, aged 80 years and older (n = 503) was studied.

methodsScreening Tool of Older People's Prescriptions (STOPP-2, misuse) and Screening Tool to Alert to Right Treatment (START-2, underuse) criteria were cross-referenced and linked to the medication use (in Anatomical Therapeutic Chemical coding) and clinical problems. Survival analysis until death or first hospitalization was performed at 18 months after inclusion using Kaplan-Meier, with Cox regression to control for covariates.

resultsMean age was 84.4 (range 80-102) years. Mean number of medications prescribed was 5 (range 0-16). Polypharmacy (≥5 medications, 58%), underuse (67%) and misuse (56%) were high. Underuse and misuse coexisted in 40% and were absent in 17% of the population. A higher number of prescribed medications was correlated with more misused medications (r

conclusionIP (polypharmacy, underuse and misuse) was highly prevalent in adults, aged 80 years and older. Surprisingly, underuse and not misuse had strong associations with mortality and hospitalization.

Indexed as

Independent LivingSurvival AnalysisAged, 80 and overFemaleHospitalizationHumansInappropriate PrescribingMalePolypharmacyPrescription Drug Misuseaged 80 years and overhospitalizationinappropriate prescribingmortalitypolypharmacyprimary care

Identifiers

PMID27426227
PMCPMC5061799

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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.