Martyn‐St James, M., Faria, R., Wong, R. et al. (1 more author) (2021) Evidence for the impact of interventions and medicines reconciliation on problematic polypharmacy in the UK: a rapid review of systematic reviews. British Journal of Clinical Pharmacology, 87 (1). pp. 42-75. ISSN 0306-5251
Abstract
This was a rapid review of systematic reviews (SRs) on problematic polypharmacy (PP) in the UK. Commissioner‐defined topics were: burden of PP, interventions to reduce PP, implementation activities to increase uptake of interventions, and efficient handover between primary and secondary care to reduce PP..
Databases including Medline were searched to June 2019, SR quality was assessed using AMSTAR‐2 (A MeaSurement Tool to Assess systematic Reviews). A narrative synthesis was undertaken.
Except for burden of PP (SRs had to include UK studies), there were no restrictions on country, location of care, or outcomes.
Nine SRs were included. On burden, three SRs (including six UK studies) found a high prevalence of polypharmacy in long‐term. PP was associated with mortality, although unclear if causal; with no information on costs or health consequences. On interventions, six reviews (27 UK studies) found that interventions can reduce PP, but no effects on health outcomes. On handover between primary and secondary care, one review (two UK studies) found medicine reconciliation activities to reduce medication discrepancies at care transitions reduce PP, although the evidence is low quality. No SRs on implementation activities to increase uptake of interventions were found..
SR quality was variable, with some concerns regarding meta‐analysis methods.
Evidence of the extent of PP in the UK, and what interventions to address it are effective in the UK, is limited. Future UK research is needed on: the prevalence and consequences of PP; effectiveness and cost‐effectiveness of interventions to reduce PP; and barriers and activities to ensure uptake.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 The British Pharmacological Society. This is an author-produced version of a paper subsequently published in British Journal of Clinical Pharmacology. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Polypharmacy; overprescribing; rapid review; systematic review; evidence based medicine; health policy |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 27 May 2020 15:53 |
Last Modified: | 16 Nov 2021 15:31 |
Status: | Published |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1111/bcp.14368 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:161268 |