Evidence map›Paper›PMID 37442984›Full record

Observational studyBMC geriatrics2023

Frequency and impact of medication reviews for people aged 65 years or above in UK primary care: an observational study using electronic health records.

Rebecca M Joseph, Roger D Knaggs, Carol A C Coupland, Amelia Taylor, Yana Vinogradova, Debbie Butler, Louisa Gerrard, David Waldram, Barbara Iyen, Ralph K Akyea and 3 more

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

Observational study in BMC geriatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.0field-weighted citation impact, top 14% 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

8 citing papers in PubMed, 11 citations in OpenAlex.

  1. Observational
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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

13 authors at 3 institutions in 1 country.

Rebecca M JosephCentre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-0147-0712
Roger D KnaggsSchool of Pharmacy, University of Nottingham, Nottingham, UK.ORCID 0000-0003-1646-8321
Carol A C CouplandCentre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-2327-3306
Amelia TaylorCentre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-8875-5779
Yana VinogradovaCentre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-3030-5257
Debbie ButlerNational Institute for Health and Care Research MindTech MedTech Co-operative, The Institute of Mental Health, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, UK.
Louisa GerrardNational Institute for Health and Care Research MindTech MedTech Co-operative, The Institute of Mental Health, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, UK.
David WaldramNational Institute for Health and Care Research MindTech MedTech Co-operative, The Institute of Mental Health, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, UK.ORCID 0000-0001-9075-927X
Barbara IyenCentre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0001-9720-1180
Ralph K AkyeaCentre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0003-4529-8237
Darren M AshcroftCentre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.ORCID 0000-0002-2958-915X
Anthony J AveryCentre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0001-7591-4438
Ruth H JackCentre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK. ruth.jack@nottingham.ac.uk.ORCID 0000-0003-4009-020X
University of Nottingham · GBNottingham University Hospitals NHS Trust · GBManchester Academic Health Science Centre · GB

Funding

NRSA Training CoreTL1TR002016 · NCATS · PENNSYLVANIA STATE UNIV HERSHEY MED CTR · PI THOMAS, GAIL D. · 2016 to 2025
$3.4M
NIHR Greater Manchester Patient Safety Translational Research Centre PSTRC-2016-003NIHR School for Primary Care Research 587
6 · The paper itself

Abstract

backgroundMedication reviews in primary care provide an opportunity to review and discuss the safety and appropriateness of a person's medicines. However, there is limited evidence about access to and the impact of routine medication reviews for older adults in the general population, particularly in the UK. We aimed to quantify the proportion of people aged 65 years and over with a medication review recorded in 2019 and describe changes in the numbers and types of medicines prescribed following a review.

methodsWe used anonymised primary care electronic health records from the UK's Clinical Practice Research Datalink (CPRD GOLD) to define a population of people aged 65 years or over in 2019. We counted people with a medication review record in 2019 and used Cox regression to estimate associations between demographic characteristics, diagnoses, and prescribed medicines and having a medication review. We used linear regression to compare the number of medicines prescribed as repeat prescriptions in the three months before and after a medication review. Specifically, we compared the 'prescription count' - the maximum number of different medicines with overlapping prescriptions people had in each period.

resultsOf 591,726 people prescribed one or more medicines at baseline, 305,526 (51.6%) had a recorded medication review in 2019. Living in a care home (hazard ratio 1.51, 95% confidence interval 1.40-1.62), medication review in the previous year (1.83, 1.69-1.98), and baseline prescription count (e.g. 5-9 vs 1 medicine 1.41, 1.37-1.46) were strongly associated with having a medication review in 2019. Overall, the prescription count tended to increase after a review (mean change 0.13 medicines, 95% CI 0.12-0.14).

conclusionsAlthough medication reviews were commonly recorded for people aged 65 years or over, there was little change overall in the numbers and types of medicines prescribed following a review. This study did not examine whether the prescriptions were appropriate or other metrics, such as dose or medicine changes within the same class. However, by examining the impact of medication reviews before the introduction of structured medication review requirements in England in 2020, it provides a useful benchmark which these new reviews can be compared with.

Indexed as

Electronic Health RecordsMedication ReviewAgedEnglandHumansPolypharmacyPrescriptionsPrimary Health CareGeneral PracticeMedication ReviewOlder AdultsPolypharmacyRoutinely Collected Health Data

Identifiers

PMID37442984
PMCPMC10347807
OpenAlexW4384155871

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.