Evidence map›Paper›PMID 38619121›Full record

ArticleAge and ageing2024

Effects of medication management in geriatric patients who have fallen: results of the EMMA mixed-methods study.

Stephanie Clemens, Bernhard Iglseder, Reinhard Alzner, Magdalena Kogler, Olaf Rose, Patrick Kutschar, Simon Krutter, Karin Kanduth, Christina Dückelmann, Maria Flamm and 1 more

Open access · hybridAbstract read
In one paragraph

Article in Age and ageing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 28% 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

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. 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

11 authors at 2 institutions in 2 countries.

Stephanie ClemensInstitute of Pharmacy, Pharmaceutical Biology and Clinical Pharmacy, Paracelsus Medical University, Salzburg, Austria.ORCID 0000-0002-8788-9329
Bernhard IglsederDepartment of Geriatric Medicine, Christian Doppler Klinik, Paracelsus Medical University, Ignaz-Harrer-Straße 79, A-5020, Salzburg, Austria.ORCID 0000-0002-6132-8670
Reinhard AlznerDepartment of Geriatric Medicine, Christian Doppler Klinik, Paracelsus Medical University, Ignaz-Harrer-Straße 79, A-5020, Salzburg, Austria.
Magdalena KoglerLandesapotheke Salzburg, Salzburg, Austria.
Olaf RoseInstitute of Pharmacy, Pharmaceutical Biology and Clinical Pharmacy, Paracelsus Medical University, Salzburg, Austria.ORCID 0000-0003-1681-4909
Patrick KutscharInstitute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria.ORCID 0000-0002-2029-2552
Simon KrutterInstitute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria.ORCID 0000-0001-5788-9574
Karin KanduthInstitute of Pharmacy, Pharmaceutical Biology and Clinical Pharmacy, Paracelsus Medical University, Salzburg, Austria.
Christina DückelmannInstitute of Pharmacy, Pharmaceutical Biology and Clinical Pharmacy, Paracelsus Medical University, Salzburg, Austria.
Maria FlammInstitute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria.ORCID 0000-0003-0816-6657
Johanna PachmayrInstitute of Pharmacy, Pharmaceutical Biology and Clinical Pharmacy, Paracelsus Medical University, Salzburg, Austria.
Paracelsus Medical University · ATSalzburger Landeskliniken · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundcomprehensive medication management (CMM) can reduce medication-related risks of falling. However, knowledge about inter-individual treatment effects and patient-related barriers remains scarce.

objectiveto gain in-depth insights into how geriatric patients who have fallen view their medication-related risks of falling and to identify effects and barriers of a CMM in preventing falls.

designcomplementary mixed-methods pre-post study, based on an embedded quasi-experimental model.

settinggeriatric fracture centre.

methodsqualitative, semi-structured interviews framed the CMM intervention, including a follow-up period of 12 weeks. Interviews explored themes of falling, medication-related risks, post-discharge acceptability and sustainability of interventions using qualitative content analysis. Optimisation of pharmacotherapy was assessed via changes in the weighted and summated Medication Appropriateness Index (MAI) score, number of fall-risk-increasing drugs (FRID) and potentially inappropriate medications (PIM) according to the Fit fOR The Aged and PRISCUS lists using parametric testing.

resultsthirty community-dwelling patients aged ≥65 years, taking ≥5 drugs and admitted after an injurious fall were recruited. The MAI was significantly reduced, but number of FRID and PIM remained largely unchanged. Many patients were open to medication reduction/discontinuation, but expressed fear when it came to their personal medication. Psychosocial issues and pain increased the number of indications. Safe alternatives for FRID were frequently not available. Psychosocial burden of living alone, fear, lack of supportive care and insomnia increased after discharge.

conclusionas patients' individual attitudes towards trauma and medication were not predictable, an individual and longitudinal CMM is required. A standardised approach is not helpful in this population.

Indexed as

Accidental FallsFractures, BoneAftercareAgedHumansMedication Therapy ManagementPatient Dischargefall-risk-increasing drugsfracturegeriatricsmedication managementolder peoplepatient perspectivesqualitative research

Identifiers

PMID38619121
PMCPMC11041409
OpenAlexW4394820262

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.