Evidence map›Paper›PMID 34218816›Full record

ArticleSystematic reviews2021

Prevalence of polypharmacy and associated adverse health outcomes in adult patients with chronic kidney disease: protocol for a systematic review and meta-analysis.

Ikechi G Okpechi, Mohammed M Tinwala, Shezel Muneer, Deenaz Zaidi, Feng Ye, Laura N Hamonic, Maryam Khan, Naima Sultana, Scott Brimble, Allan Grill and 13 more

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

Article in Systematic reviews, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 17% 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

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
  5. Article
  6. Article
  7. Review
  8. Observational
  9. Article
  10. Article
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

23 authors at 7 institutions in 4 countries.

Ikechi G OkpechiDepartment of Medicine, University of Alberta, Edmonton, AB, Canada.ORCID 0000-0002-6545-9715
Mohammed M TinwalaDepartment of Medicine, University of Alberta, Edmonton, AB, Canada.
Shezel MuneerDepartment of Medicine, University of Alberta, Edmonton, AB, Canada.
Deenaz ZaidiDepartment of Medicine, University of Alberta, Edmonton, AB, Canada.
Feng YeDepartment of Medicine, University of Alberta, Edmonton, AB, Canada.
Laura N HamonicJohn W. Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada.
Maryam KhanFaculty of Science, University of Alberta, Edmonton, Alberta, Canada.
Naima SultanaFaculty of Science, University of Alberta, Edmonton, Alberta, Canada.
Scott BrimbleDivision of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Allan GrillDepartment of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
Scott KlarenbachDepartment of Medicine, University of Alberta, Edmonton, AB, Canada.
Cliff LindemanDepartment of Family Medicine, University of Alberta, Edmonton, AB, Canada.
Amber MolnarDivision of Nephrology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Dorothea NitschDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Paul RonksleyDepartment of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
Soroush ShojaiDepartment of Medicine, University of Alberta, Edmonton, AB, Canada.
Boglarka SoosDepartment of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
Navdeep TangriDepartment of Medicine, Max Rady College of Medicine, Winnipeg, MB, Canada.
Stephanie ThompsonDepartment of Medicine, University of Alberta, Edmonton, AB, Canada.
Delphine TuotDivision of Nephrology, University of California, San Francisco, CA, USA.
Neil DrummondDepartment of Family Medicine, University of Alberta, Edmonton, AB, Canada.
Dee ManginDepartment of Family Medicine, McMaster University, Hamilton, ON, Canada.
Aminu K BelloDepartment of Medicine, University of Alberta, Edmonton, AB, Canada. aminu1@ualberta.ca.
University of Alberta · CAMcMaster University · CAUniversity of Calgary · CAImpact · CALondon School of Hygiene & Tropical Medicine · GBUniversity of California, San Francisco · USUniversity of Toronto · CA

Funding

CIHR
6 · The paper itself

Abstract

backgroundPolypharmacy, often defined as the concomitant use of ≥ 5 medications, has been identified as a significant global public health threat. Aging and multimorbidity are key drivers of polypharmacy and have been linked to a broad range of adverse health outcomes and mortality. Patients with chronic kidney disease (CKD) are particularly at high risk of polypharmacy and use of potentially inappropriate medications given the numerous risk factors and complications associated with CKD. The aim of this systematic review will be to assess the prevalence of polypharmacy among adult patients with CKD, and the potential association between polypharmacy and adverse health outcomes within this population. METHODS/

designWe will search empirical databases such as MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, and PsycINFO and grey literature from inception onwards (with no language restrictions) for observational studies (e.g., cross-sectional or cohort studies) reporting the prevalence of polypharmacy in adult patients with CKD (all stages including dialysis). Two reviewers will independently screen all citations, full-text articles, and extract data. Potential conflicts will be resolved through discussion. The study methodological quality will be appraised using an appropriate tool. The primary outcome will be the prevalence of polypharmacy. Secondary outcomes will include any adverse health outcomes (e.g., worsening kidney function) in association with polypharmacy. If appropriate, we will conduct random effects meta-analysis of observational data to summarize the pooled prevalence of polypharmacy and the associations between polypharmacy and adverse outcomes. Statistical heterogeneity will be estimated using Cochran's Q and I DISCUSSION: Given that polypharmacy is a major and a growing public health issue, our findings will highlight the prevalence of polypharmacy, hazards associated with it, and medication thresholds associated with adverse outcomes in patients with CKD. Our study will also draw attention to the prognostic importance of improving medication practices as a key priority area to help minimize the use of inappropriate medications in patients with CKD. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: [ CRD42020206514 ].

Indexed as

PolypharmacyRenal Insufficiency, ChronicAdultCross-Sectional StudiesHumansMeta-Analysis as TopicOutcome Assessment, Health CarePrevalenceRenal DialysisSystematic Reviews as TopicAdverse effectsCKDElderlyMultimorbidityPolypharmacyPrescriptions

Identifiers

PMID34218816
PMCPMC8256607
OpenAlexW3178454702

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.