ReviewEuropean geriatric medicine2021
Underprescription of medications in older adults: causes, consequences and solutions-a narrative review.
Review in European geriatric medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled 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.
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
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Interventions to improve medicines optimisation in frail older patients in secondary and acute care settings: a systematic review of randomised controlled trials and non-randomised studies.International journal of clinical pharmacy · 2022Pooled it
- Global under- and overprescribing of drugs-a scoping review.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- Deprescribing in Older People: A Clinical Practice Guideline Summary.The Medical journal of Australia · 2026Article
- Applying a multidisciplinary intervention for drug adequacy in an intermediate care hospital (AMIDA-ICH): study protocol of a complex intervention trial.Frontiers in medicine · 2026Article
- Age-related disparities in biologic therapy initiation among rheumatoid arthritis patients: Insights from a large retrospective cohort study.Clinical rheumatology · 2025Article
- Characteristics of Drug-RElated Hospitalizations for Nursing HOme Residents: Cross-Sectional RENHO Study.Drug safety · 2025Article
- Ageism in a health-related context: the physiological, psychological, and behavioral impacts of subtle age discrimination on older adults.Scientific reports · 2025Article
- Drugs and Healthy Aging.Drugs & aging · 2025Review
- Characteristics and treatment options of 272,152 geriatric patients with very high and high fracture risk.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Hemoglobin-to-Creatinine Ratio Predicts One-Year Adverse Clinical Outcomes in ST-Elevation Myocardial Infarction: Retrospective and Propensity Score Matched Analysis.Journal of clinical medicine · 2025Article
- Differences in Pharmacological Treatment of Heart Failure Among Persons with or without Major Cognitive Disorder: A Cross-Sectional Study Based on National Registries in Sweden.Drugs & aging · 2024Article
- Influence of loop diuretics on denosumab-induced hypocalcaemia in osteoporosis: a retrospective observational analysis.Journal of pharmaceutical health care and sciences · 2024Article
- Construction and verification of a risk prediction model for cognitive frailty in older patients with chronic obstructive pulmonary disease and diabetes mellitus.The Journal of international medical research · 2024Article
- Assessing Decision Fatigue in General Practitioners' Prescribing Decisions Using the Australian BEACH Data Set.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Article
- Effects of medication management in geriatric patients who have fallen: results of the EMMA mixed-methods study.Age and ageing · 2024Article
- Rural-urban differences in use of health services before and after dementia diagnosis: a retrospective cohort study.BMC health services research · 2024Article
- The use of a multi-disciplinary geriatric telemedicine service (TELEG) and its acceptance at a tertiary care centre in Malaysia.BMC geriatrics · 2024Article
- Optimizing pharmacotherapy and deprescribing strategies in older adults living with multimorbidity and polypharmacy: EuGMS SIG on pharmacology position paper.European geriatric medicine · 2023Article
- Cohort study investigating gout flares and management in UK general practice.BMC primary care · 2023Article
- STOPP/START version 3: even better with age.European geriatric medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeUnder-prescription is defined as the omission of a medication that is indicated for the treatment of a condition or a disease, without any valid reason for not prescribing it. The aim of this review is to provide an updated overview of under-prescription, summarizing the available evidence concerning its prevalence, causes, consequences and potential interventions to reduce it.
methodsA PubMed search was performed, using the following keywords: under-prescription; under-treatment; prescribing omission; older adults; polypharmacy; cardiovascular drugs; osteoporosis; anticoagulant. The list of articles was evaluated by two authors who selected the most relevant of them. The reference lists of retrieved articles were screened for additional pertinent studies.
resultsAlthough several pharmacological therapies are safe and effective in older patients, under-prescription remains widespread in the older population, with a prevalence ranging from 22 to 70%. Several drugs are underused, including cardiovascular, oral anticoagulant and anti-osteoporotic drugs. Many factors are associated with under-prescription, e.g. multi-morbidity, polypharmacy, dementia, frailty, risk of adverse drug events, absence of specific clinical trials in older patients and economic factors. Under-prescription is associated with negative consequences, such as higher risk of cardiovascular events, worsening disability, hospitalization and death. The implementation of explicit criteria for under-prescription, the use of the comprehensive geriatric assessment by geriatricians, and the involvement of a clinical pharmacist seem to be promising options to reduce under-prescription.
conclusionUnder-prescription remains widespread in the older population. Further studies should be performed, to provide a better comprehension of this phenomenon and to confirm the efficacy of corrective interventions.
Indexed as
Identifiers
What OpenQuestion holds
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.