Evidence map›Paper›PMID 41118061›Full record

ArticleInternational journal of clinical pharmacy2025

Addressing potentially inappropriate prescribing in care homes: regional evaluation of a pharmacist-led model in Northern Ireland.

Ann Sinéad Doherty, Gary Adamson, John Mallett, Carmel Darcy, Hilary McKee, Anne Friel, Michael G Scott, E F Ruth Miller

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Article in International journal of clinical pharmacy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

8 authors.

Ann Sinéad DohertySchool of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, UK. adoherty@ucc.ie.ORCID http://orcid.org/0000-0003-4149-1574
Gary AdamsonSchool of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, UK.ORCID http://orcid.org/0000-0001-8574-8947
John MallettSchool of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, UK.ORCID http://orcid.org/0000-0001-7539-3329
Carmel DarcyPharmacy, Altnagelvin Area Hospital, Western Health and Social Care Trust, Derry, BT47 6SB, UK.
Hilary McKeeNorthern Health and Social Care Trust, Antrim, BT41 2RL, UK.
Anne FrielPharmacy, Altnagelvin Area Hospital, Western Health and Social Care Trust, Derry, BT47 6SB, UK.
Michael G ScottMedicines Optimisation and Innovation Centre, Pine House Antrim Area Hospital Site, Northern Health and Social Care Trust, Antrim, BT41 2RL, UK.ORCID http://orcid.org/0000-0003-4048-0937
E F Ruth MillerPharmacy, Altnagelvin Area Hospital, Western Health and Social Care Trust, Derry, BT47 6SB, UK.ORCID http://orcid.org/0000-0001-9534-2940

Funding

Ulster University Vice Chancellor's Research ScholarshipWestern Health and Social Care Trust Research Discretionary Fund
6 · The paper itself

Abstract

introductionPotentially inappropriate prescribing (PIP) increases the risk for medication-related harm amongst older adults, with those in long-term care at particular risk.

aimThis study sought to evaluate a medicines optimisation pharmacist case management model for older adults in care homes in Northern Ireland (NI).

methodSecondary analysis of prospective data collected during the case management model delivered to older adults (≥ 65 years) across 32 care homes in NI (N = 1,095). Medication Appropriateness Index (MAI) scores were compared at baseline and post-intervention. Variability in MAI per medication score change (ΔMAI) was examined using multiple linear regression. Multiple logistic and Poisson regressions examined potential associations between ΔMAI and secondary outcomes, including unplanned hospital admissions (all-cause); general practitioner (GP) call-outs; out-of-hours (OOH) GP call-outs; and emergency department (ED) visits.

resultsPIP was highly prevalent at baseline (83.5%; n = 914). A significant reduction in MAI (per medication) score was observed from pre to post-intervention; 82% (n = 898) of participants experienced some MAI score improvement. Overall, 3,044 clinical interventions were delivered; 2,062 medications were stopped, 141 medications were started, and 438 dosages were changed. Several unexpected significant associations were observed between ΔMAI and GP call-outs during follow-up; sensitivity analyses suggested these findings were likely due to confounding. No association was observed between ΔMAI (per medication) and likelihood for unplanned hospital admission.

conclusionPIP is highly prevalent in NI care homes and was significantly reduced by a medicine optimisation pharmacist case management model. Clinical pharmacist input in long-term care is warranted to lessen medication-related harm for older adults.

Indexed as

Homes for the AgedInappropriate PrescribingNursing HomesPharmacistsPractice Patterns, Pharmacists'Professional RoleAgedAged, 80 and overCase ManagementFemaleHumansMaleNorthern IrelandProspective StudiesCase managementClinical pharmacy servicesNursing homesOlder adultsPotentially inappropriate prescribing

Identifiers

PMID41118061

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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.