ArticleJournal of the American Geriatrics Society2019
Medication Appropriateness in Vulnerable Older Adults: Healthy Skepticism of Appropriate Polypharmacy.
Article in Journal of the American Geriatrics Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Oxytocin in old age psychiatry: A systematic review of the safety of using intranasal oxytocin in older adults.Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists · 2025Pooled it
- Effect of Clinical Geriatric Assessments and Collaborative Medication Reviews by Geriatrician and Family Physician for Improving Health-Related Quality of Life in Home-Dwelling Older Patients Receiving Polypharmacy: A Cluster Randomized Clinical Trial.JAMA internal medicine · 2020Trial
- How Should Clinicians Discuss Deprescribing with Caregivers of Older Adults Living with Dementia? A Qualitative Study.Drugs & aging · 2025Article
- Physician-Reported Facilitators and Barriers for Side Effect Management of Heart Failure Medications.Journal of the American Heart Association · 2024Article
- Association between Cognitive Impairment Severity and Polypharmacy in Older Patients with Atrial Fibrillation: A Retrospective Study Using Inpatient Data from a Specialised Geriatric Hospital.Geriatrics (Basel, Switzerland) · 2024Article
- Deprescribing, shared decision-making, and older people: perspectives in primary care.Journal of pharmaceutical policy and practice · 2023Review
- Assessment of potentially inappropriate medication use among geriatric outpatients in the Slovak Republic.BMC geriatrics · 2023Article
- Sex-specific medication trajectories in older adults newly diagnosed with diabetes.Exploratory research in clinical and social pharmacy · 2023Article
- Anticholinergic co-prescribing in nursing home residents using cholinesterase inhibitors: Potential deprescribing cascade.Journal of the American Geriatrics Society · 2023Article
- Generating Practice-Based Evidence in the Use of Guideline-Recommended Combination Therapy for Secondary Prevention of Acute Myocardial Infarction.Pharmacy (Basel, Switzerland) · 2022Article
- N-of-1 trials to facilitate evidence-based deprescribing: Rationale and case study.British journal of clinical pharmacology · 2022Review
- Assessment of the appropriateness of cardiovascular preventive medication in older people: using the RAND/UCLA Appropriateness Method.BMC geriatrics · 2022Article
- Polypharmacy trajectories among older women with and without dementia: A longitudinal cohort study.Exploratory research in clinical and social pharmacy · 2021Article
- Assessing Prevalence and Factors Related to Frailty in Community-Dwelling Older Adults: A Multinomial Logistic Analysis.Journal of clinical medicine · 2021Article
- Chronic Polypharmacy with Increasing Drug Burden Index Exacerbates Frailty and Impairs Physical Function, with Effects Attenuated by Deprescribing, in Aged Mice.The journals of gerontology. Series A, Biological sciences and medical sciences · 2021Article
- [Less can be more-Examples on medication in older and geriatric patients from current studies].Der Internist · 2021Review
- Article
- Longitudinal Investigation of Older Adults' Ability to Self-Manage Complex Drug Regimens.Journal of the American Geriatrics Society · 2020Article
- "At 80 I Know Myself": Embodied Learning and Older Adults' Experiences of Polypharmacy and Perceptions of Deprescribing.Gerontology & geriatric medicineArticle
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2 authors at 1 institution in 1 country.
Funding
Abstract
Older adults are prescribed a growing number of medications. Polypharmacy, commonly considered the receipt of five or more medications, is associated with a range of adverse outcomes. There is a debate about the reason(s) why. On one side is the assertion that older persons are being prescribed too many medications, with the number of medications increasing the risk of adverse events. On the other side is the observation that polypharmacy is associated both with overprescribing of inappropriate medications and underprescribing of appropriate medications. This leads to the concept of "inappropriate" vs "appropriate" polypharmacy, with the latter resulting from the prescription of many correct medications to persons with multiple chronic conditions. Few studies have examined the health outcomes associated with adding and/or removing medications to address this debate directly. The criteria used to identify underutilized medications are based on results of randomized controlled trials that may not be generalizable to older adults. Several randomized controlled trials and many more observational studies provide evidence that these criteria overestimate medication benefits and underestimate harms. In addition, evidence suggests that the marginal effects of medications added to an already complex regimen differ from their effects when considered individually. Although in selected circumstances adding medications results in benefit to patients, patients with multimorbidity and frailty/disability have susceptibilities that can decrease the likelihood of medication benefit and increase the likelihood of harms. The identification of appropriate polypharmacy requires more robust criteria to evaluate the net effects of complex medication regimens.
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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.