Evidence map›Paper›PMID 30086742›Full record

ArticleBMC health services research2018

Effects of medication reviews on use of potentially inappropriate medications in elderly patients; a cross-sectional study in Swedish primary care.

Cecilia Lenander, Åsa Bondesson, Nina Viberg, Anders Beckman, Patrik Midlöv

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 1 pooled it
3.2field-weighted citation impact, top 8% 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

34 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.

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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 1 institution in 2 countries.

Cecilia LenanderDepartment of Clinical Sciences in Malmö, Lund University, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden. cecilia.lenander@med.lu.se.ORCID 0000-0003-0553-7432
Åsa BondessonDepartment of Clinical Sciences in Malmö, Lund University, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden.
Nina VibergDepartment of Clinical Sciences in Malmö, Lund University, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden.
Anders BeckmanDepartment of Clinical Sciences in Malmö, Lund University, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden.
Patrik MidlövDepartment of Clinical Sciences in Malmö, Lund University, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden.
Lund University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDrug use among the elderly population is generally extensive and the use of potentially inappropriate medications (PIMs) is common, which increases the risk for drug-related problems (DRP). Medication reviews are one method to improve drug therapy by identifying, preventing and solving DRPs. The aim of this study was to evaluate the effect of medication reviews on total drug use and potentially inappropriate drug use in elderly patients, as well as describe the occurrence and types of drug-related problems.

methodThis was a cross-sectional analysis to study medication reviews conducted by trained clinical pharmacists followed by team-based discussions with general practitioners (GPs) and nurses, for elderly primary care patients in Skåne, Sweden. Included in the analysis were patients ≥75 years living in nursing homes or in their own homes with home care, who received a medication review during 2011-2012. Documented DRPs were described as both the type of DRPs and as pharmacists' recommendations to the GP. The usage of ≥3 psychotropics and PIMs (antipsychotics, anticholinergics, long-acting benzodiazepines, tramadol and propiomazine) at baseline and after medication review were also studied.

resultsThe analysis included a total of 1720 patients. They were on average aged 87.5 years, used typically 11.3 drugs (range 1-35) and 61% of them used 10 drugs or more. Of the patients, 84% had at least one DRP with a mean of 2.2 DRPs/patient. Of the DRPs, 12% were attributable to PIMs. The proportion of patients with ≥ one PIM was reduced significantly (p < 0.001) as was the use of ≥3 psychotropics (p < 0.001). The most common DRP was unnecessary drug therapy (39%), followed by dose too high (21%) and wrong drug (20%). Drug withdrawal was the most common result.

conclusionThis study shows that medication reviews performed in everyday care are one way of improving drug use among elderly patients. The use of potentially inappropriate medications and use of three or more psychotropic drugs decreased after the medication review. Our study also shows that drug use is extensive in nursing home residents and elderly patients with homecare, and that unnecessary drug therapy is a common problem.

Indexed as

AgedAged, 80 and overCross-Sectional StudiesDrug Utilization ReviewFemaleGeneral PractitionersGeriatricsHumansInappropriate PrescribingIndependent LivingMaleNursesNursing HomesPharmacistsPsychotropic DrugsSwedenPsychotropic DrugsClinical pharmacistDrug-related problemsElderlyMedication reviewPotential inappropriate medicationPrimary care

Identifiers

PMID30086742
PMCPMC6081800
OpenAlexW2886185197

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Registered trials

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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.