Evidence map›Paper›PMID 38806416›Full record

ArticleBMJ open2024

Structured medication reviews for adults with multimorbidity and polypharmacy in primary care: a systematic review protocol.

Elena Lammila-Escalera, Geva Greenfield, Reham Aldakhil, Hadar Zaman, Ana Luisa Neves, Azeem Majeed, Benedict Wj Hayhoe

Abstract read
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Multimorbidity Management: A Scoping Review of Interventions and Health Outcomes.International journal of environmental research and public health · 2025
    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

7 authors.

Elena Lammila-EscaleraDepartment of Primary Care and Public Health, Imperial College London, London, UK elena.lammila-escalera20@imperial.ac.uk.ORCID 0000-0001-6805-5241
Geva GreenfieldDepartment of Primary Care and Public Health, Imperial College London, London, UK.ORCID 0000-0001-9779-2486
Reham AldakhilDepartment of Primary Care and Public Health, Imperial College London, London, UK.ORCID 0000-0002-6975-3858
Hadar ZamanSchool of Pharmacy and Medical Sciences, University of Bradford, Bradford, UK.ORCID 0000-0002-4252-2822
Ana Luisa NevesDepartment of Primary Care and Public Health, Imperial College London, London, UK.ORCID 0000-0002-7107-7211
Azeem MajeedDepartment of Primary Care and Public Health, Imperial College London, London, UK.ORCID 0000-0002-2357-9858
Benedict Wj HayhoeDepartment of Primary Care and Public Health, Imperial College London, London, UK.ORCID 0000-0002-2645-6191

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPolypharmacy is common among individuals with multimorbidity, often leading to inappropriate medication use and is associated with an increased risk of frailty, hospitalisation and mortality. Structured medication reviews (SMRs) have emerged as a promising method for optimising medication use. However, research examining their efficacy is limited. This review aims to evaluate the impact of SMRs on improving outcomes for adults with multimorbidity and polypharmacy in primary care settings. Additionally, this review seeks to identify prevailing patterns and trends in the mode of delivery of SMRs. METHODS AND ANALYSIS: A systematic review will be conducted using Ovid MEDLINE, Ovid EMBASE, Web of Science and CINAHL (1997-present). Primary outcomes will include medication-related measures such as dose, frequency and dosage form. Secondary outcomes under investigation will include physical, mental, functional and health service outcomes, as reported. Two independent reviewers will conduct the screening and data extraction, resolving disagreements through discussion. Once eligible studies are identified, the extracted data will be summarised in tabular format. The risk of bias in the articles will be assessed using either the Cochrane Risk of Bias 2 tool or the Newcastle-Ottawa scale, depending on the design of the studies retrieved. Subgroup analysis will be performed using demographic variables and modes of delivery where the data supports. If appropriate, a meta-analysis of the data extracted will be conducted to determine the impact of the SMRs on reported outcomes. If a meta-analysis is not possible due to heterogeneity, a narrative synthesis approach will be adopted. ETHICS AND DISSEMINATION: This proposed review is exempt from ethical approval as it aims to collate and summarise peer-reviewed, published evidence. This protocol and the subsequent review will be disseminated in peer-reviewed journals, conferences and patient-led lay summaries. PROSPERO REGISTRATION NUMBER: CRD42023454965.

Indexed as

MultimorbidityPolypharmacyPrimary Health CareSystematic Reviews as TopicAdultHumansInappropriate PrescribingResearch DesignCLINICAL PHARMACOLOGYPatient-Centered CareSystematic Review

Identifiers

PMID38806416
PMCPMC11138296

What OpenQuestion holds

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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.