Trial reportInternational journal of clinical pharmacy2023
Medication changes and potentially inappropriate prescribing in older patients with significant polypharmacy.
Trial report in International journal of clinical pharmacy, 2023. 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.
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
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Potentially inappropriate prescribing and falls-risk increasing drugs in people who have experienced a fall: a systematic review and meta-analysis.Age and ageing · 2025Pooled it
- The effectiveness and cost of integrating pharmacists within general practice to optimize prescribing and health outcomes in primary care patients with polypharmacy: a systematic review.BMC primary care · 2023Pooled it
- Incidence and duration of hospital-initiated opioids, benzodiazepines and antipsychotics: a retrospective cohort study.International journal of clinical pharmacy · 2026Article
- Article
- Pharmacist-Led Interventions for Polypharmacy Management in Older Adults: A Systematic Review of Strategies and Outcomes in the United Kingdom and the Republic of Ireland.Pharmacy (Basel, Switzerland) · 2025Review
- Impact of eliciting treatment priorities on analgesic prescribing in older patients with high levels of polypharmacy.Family practice · 2025Article
- Multimorbidity Management: A Scoping Review of Interventions and Health Outcomes.International journal of environmental research and public health · 2025Article
- Core medication use in general practice prescriptions: A pilot study evaluating the Drug Utilization 90% Index in Irish general practice.British journal of clinical pharmacology · 2025Observational
- Awareness and use of tools to identify potentially inappropriate prescribing among physicians and pharmacists in Saudi Arabia: a nationwide cross-sectional study.International journal of clinical pharmacy · 2025Article
- Assessing causality in deprescribing studies: A focus on adverse drug events and adverse drug withdrawal events.Journal of the American Geriatrics Society · 2025Article
- Developing and assessing the usability of a prescribing quality and safety dashboard in Irish general practice: protocol for a qualitative study.HRB open research · 2025Article
- Defining, identifying and addressing problematic polypharmacy within multimorbidity in primary care: a scoping review.BMJ open · 2024Article
- Factors affecting clinical pharmacist decision-making when reviewing and prescribing z-drugs in primary care: a qualitative interview study.International journal of clinical pharmacy · 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
7 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundNumber of medicines and medicines appropriateness are often used as outcome measures to evaluate the effectiveness of deprescribing interventions.
aimThe aim of this study was to evaluate changes in prescribing, potentially inappropriate prescriptions (PIP) and prescribing of low-value medicines in older people with multimorbidity and significant polypharmacy.
methodThis study was a retrospective secondary analysis of prescription data from a cluster randomised controlled trial involving 404 participants aged ≥ 65 years and prescribed ≥ 15 repeat medicines from 51 different general practices. For this study, repeat medications at baseline and follow-up (~ 1 year later) were assigned Anatomical Therapeutic Classification (ATC) codes. Outcomes were the most commonly prescribed and potentially inappropriately prescribed drug groups, the most frequently discontinued or initiated drug groups and the number of changes per person between baseline and follow-up.
resultsThere were 7051 medicines prescribed to 404 participants at baseline. There was a median of 17 medicines (IQR 15-19) at baseline and 16 (IQR 14-19) at follow-up. PIP represented 17.1% of prescriptions at baseline and 15.7% (n = 6777) at follow-up. There were reductions in the prescription of most drug groups with the largest reduction in antiplatelet prescriptions. Considering medication discontinuations, initiations and switches, there was a median of five medication changes per person (range 0-30, IQR 3-9) by follow-up. There were 95 low-value prescriptions at baseline reducing to 78 at follow-up.
conclusionThe number of medication changes per person was not reflected by summarising medication count at two time points, highlighting the complexity of prescribing for patients with polypharmacy. Frequent medication changes has potentially important implications for patients in terms of adherence and medication safety. TRIAL REGISTRY: The SPPiRE trial was registered prospectively on the ISRCTN registry (ISRCTN12752680).
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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.