Evidence map›Paper›PMID 29589065›Full record

ArticleEuropean journal of clinical pharmacology2018

Relationship between frailty, polypharmacy, and underprescription in older adults living in nursing homes.

Marta Gutiérrez-Valencia, Mikel Izquierdo, Esther Lacalle-Fabo, Itxaso Marín-Epelde, María Fernanda Ramón-Espinoza, Thamara Domene-Domene, Álvaro Casas-Herrero, Arkaitz Galbete, Nicolás Martínez-Velilla

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Article in European journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 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.

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

13 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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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

9 authors.

Marta Gutiérrez-ValenciaDepartment of Geriatrics, Complejo Hospitalario de Navarra, C/Irunlarrea 3, 31008, Pamplona, Spain. marta.guva@gmail.com.ORCID http://orcid.org/0000-0002-3229-6614
Mikel IzquierdoHealth Science Department, Public University of Navarra, Pamplona, Navarra, Spain.
Esther Lacalle-FaboPharmacy Department, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.
Itxaso Marín-EpeldeDepartment of Geriatrics, Complejo Hospitalario de Navarra, C/Irunlarrea 3, 31008, Pamplona, Spain.
María Fernanda Ramón-EspinozaDepartment of Geriatrics, Complejo Hospitalario de Navarra, C/Irunlarrea 3, 31008, Pamplona, Spain.
Thamara Domene-DomeneDepartment of Geriatrics, Complejo Hospitalario de Navarra, C/Irunlarrea 3, 31008, Pamplona, Spain.
Álvaro Casas-HerreroDepartment of Geriatrics, Complejo Hospitalario de Navarra, C/Irunlarrea 3, 31008, Pamplona, Spain.
Arkaitz GalbeteNavarrabiomed-Departamento de Salud-UPNA, Pamplona, Spain.
Nicolás Martínez-VelillaDepartment of Geriatrics, Complejo Hospitalario de Navarra, C/Irunlarrea 3, 31008, Pamplona, Spain.

Funding

REFBIO REFBIO13/BIOD/002
6 · The paper itself

Abstract

purposeFrailty, polypharmacy, and underprescription are considered a major matter of concern in nursing homes, but the possible relationships between them are not well known. The aim is to examine the possible association between medication underprescription, polypharmacy, and frailty in older people living in nursing homes.

methodsA cross-sectional analysis from a concurrent cohort study, including 110 subjects ≥ 65 years living in two nursing homes. Four frailty scales were applied; polypharmacy was defined as ≥ 5 medications and underprescription was measured with Screening Tool to Alert to Right Treatment (START) criteria. Logistic regression models were performed to assess the associations.

resultsThe mean age was 86.3 years (SD 7.3) and 71.8% were female. 73.6% of subjects took ≥ 5 chronic medications and 60.9% met one or more START criteria. The non-frail participants took more medications than the frail subjects according to the imputated frailty Fried criteria (8.1 vs 6.7, p = 0.042) and the FRAIL-NH scale (7.8 vs 6.8, p = 0.026). Multivariate analyses did not find an association between frailty and polypharmacy. Frail participants according to the Fried criteria met a higher number of START criteria (1.9 vs 1.0, p = 0.017), and had a higher prevalence of underprescription (87.5 vs 50.0%), reaching the limit of statistical significance in multivariate analysis.

conclusionThe positive association found in previous studies between frailty and polypharmacy cannot be extrapolated to institutionalized populations. There is a trend towards higher rates of underprescription in frail subjects. Underprescription in frail older adults should be redefined and new strategies to measure it should be developed.

Indexed as

PolypharmacyAgedAged, 80 and overDrug UtilizationFemaleFrail ElderlyFrailtyHumansInappropriate PrescribingMaleNursing HomesSpainFrailtyNursing homesPolypharmacyUnderprescription

Identifiers

PMID29589065

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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.