Cochrane · systematic review · CD008165
Interventions to improve the appropriate use of polypharmacy for older people
Cole, JA, Gonçalves-Bradley, DC, Alqahtani, M, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 5 · 71.4%Low 2 · 28.6%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyPharmaceutical care compared with usual care for older people receiving polypharmacy
Population: older people receiving polypharmacy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Medication appropriateness (as measured by an implicit tool; lower scores are better) From baseline to Pharmaceutical care vs usual care | no estimate extracted | 8 studies · 947 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
The number of potentially inappropriate medications (PIMs) Pharmaceutical care vs usual care | no estimate extracted | 9 studies · 2404 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
The proportion of patients with one or more potentially inappropriate medication (PIM) Pharmaceutical care vs usual care | RR 0.81 [0.68, 0.98] | 13 studies · 4534 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
The number of potential prescribing omissions (PPOs) Pharmaceutical care vs usual care | no estimate extracted | 3 studies · 691 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
The proportion of patients with one or more potential prescribing omission (PPO) Pharmaceutical care vs usual care | RR 0.5 [0.27, 0.91] | 7 studies · 2765 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Hospital admissions Pharmaceutical care vs usual care | no estimate extracted | 14 studies · 4797 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Quality of life Pharmaceutical care vs usual care | no estimate extracted | 16 studies · 7458 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Pharmaceutical care compared with usual care for older people receiving polypharmacy
Population: older people receiving polypharmacy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Medication appropriateness (as measured by an implicit tool) From baseline to Pharmaceutical care vs usual care | no estimate extracted | 5 studies · 517 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
The number of potentially inappropriate medications (PIMs) Pharmaceutical care vs usual care | no estimate extracted | 7 studies · 1832 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
The proportion of patients with one or more potentially inappropriate medications (PIMs) Pharmaceutical care vs usual care | no estimate extracted | 11 studies · 3079 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
The number of potential prescribing omissions (PPOs) Pharmaceutical care vs usual care | no estimate extracted | 2 studies · 569 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
The proportion of patients with one or more potential prescribing omissions (PPOs) Pharmaceutical care vs usual care | no estimate extracted | 5 studies · 1310 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Hospital admissions Pharmaceutical care vs usual care | no estimate extracted | 12 studies · 4052 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Quality of Life Pharmaceutical care vs usual care | no estimate extracted | 12 studies · 3211 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Pharmaceutical care compared with usual care for older people receiving polypharmacy
Population: older people receiving polypharmacy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Summated MAI score Summated MAI score post intervention Pharmaceutical care vs usual care | no estimate extracted | 5 studies · 965 participants | Low Downgraded: risk of bias |
Change in MAI score Change in MAI score from baseline to Pharmaceutical care vs usual care | no estimate extracted | 4 studies · 424 participants | Very low Downgraded: risk of bias |
Number of Beers drugs per participant The number of Beers drugs per participant post intervention Pharmaceutical care vs usual care | no estimate extracted | 2 studies · 586 participants | Very low Downgraded: risk of bias |
Pharmaceutical care compared to usual care for older people
Population: older people
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Summated MAI score MAI Pharmaceutical care vs usual care | no estimate extracted | 5 studies · 965 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Change in MAI score The change in the MAI Pharmaceutical care vs usual care | no estimate extracted | 4 studies · 424 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Number of Beers drugs per patient The Beers criteria Pharmaceutical care vs usual care | no estimate extracted | 3 studies · 1440 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |