Evidence map›Paper›PMID 28764876›Full record

SynthesisJournal of the American Medical Directors Association2017

Determinants of Potentially Inappropriate Medication Use in Long-Term and Acute Care Settings: A Systematic Review.

Stephanie K Nothelle, Ritu Sharma, Allison H Oakes, Madeline Jackson, Jodi B Segal

Open access · greenAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the American Medical Directors Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 4 pooled it
3.9field-weighted citation impact, top 7% 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

36 citing papers in PubMed, 4 syntheses or guidelines pooled it, 67 citations in OpenAlex.

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  9. Use of potentially inappropriate medication for elderly patients in tertiary care hospital of Riyadh, Saudi Arabia.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2024
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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

5 authors at 2 institutions in 1 country.

Stephanie K NothelleDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: snothel1@jhmi.edu.
Ritu SharmaJohns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Allison H OakesJohns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Madeline JacksonJohns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Jodi B SegalDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Johns Hopkins University Center for Health Services and Outcomes Research, Baltimore, MD.
Johns Hopkins University · USJohns Hopkins Medicine · US

Funding

TRAINING IN HEALTH SERVICES RESEARCHT32HS000029 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI DY, SYDNEY MORSS · 1987 to 2024
$8.3M
Towards Understanding the Patient Experience of Overuse of Medical ResourcesK24AG049036 · NIA · JOHNS HOPKINS UNIVERSITY · PI SEGAL, JODI B. · 2015 to 2024
$1.6M
AHRQ HHS T32 HS000029NIA NIH HHS K24 AG049036
6 · The paper itself

Abstract

backgroundPotentially inappropriate medications (PIMs) are widely used in institutionalized older adults, yet the key determinants that drive their use are incompletely characterized.

methodsWe systematically searched published literature within MEDLINE and Embase from January 1998 to March 2017. We searched for studies conducted in the United States that described determinants of PIM use in adults ≥60 years of age in a nursing home or residential care facility, in the emergency department (ED), or in the hospital. Paired reviewers independently screened abstracts and full-text articles, assessed quality, and extracted data.

resultsAmong 30 included articles, 12 examined PIM use in the nursing home or residential care settings, 4 in the ED, 12 in acute care hospitals, and 2 across settings. The Beers criteria were most frequently used to identify PIM use, which ranged from 3.6% to 92.0%. Across all settings, the most common determinants of PIM use were medication burden and geographic region. In the nursing home, the most common additional determinants were younger age, and diagnoses of depression or diabetes. In both the ED and hospital, patients receiving care in the West, Midwest, and South, relative to the Northeast, were at greater risk of receiving a PIM. Very few studies examined clinician determinants of PIM use; geriatricians used fewer PIMs in the hospital than other clinicians.

conclusionsAmong older adults, those who are on many medications are at increased risk for PIM use across multiple settings. We propose that careful testing of interventions that target modifiable determinants are indicated to assess their impact on PIM use.

Indexed as

Clinical Decision-MakingInappropriate PrescribingNursing HomesFemaleHumansLong-Term CareMaleacute careinappropriate prescribinglong-term careOveruse

Identifiers

PMID28764876
PMCPMC5581209
OpenAlexW2740194124

What OpenQuestion holds

Textmetadata
LicenceTDM
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.