Davies, Laurie, Spiers, Gemma, Kingston, Andrew et al. (3 more authors) (2020) Adverse Outcomes of Polypharmacy in Older People:Systematic Review of Reviews. Journal of the American Medical Directors Association. pp. 181-187.
Abstract
Objective Polypharmacy is widespread among older people, but the adverse outcomes associated with it are unclear. We aim to synthesize current evidence on the adverse health, social, medicines management, and health care utilization outcomes of polypharmacy in older people. Design A systematic review, of systematic reviews and meta-analyses of observational studies, was conducted. Eleven bibliographic databases were searched from 1990 to February 2018. Quality was assessed using AMSTAR (A Measurement Tool to Assess Systematic Reviews). Setting and participants Older people in any health care setting, residential setting, or country. Results Twenty-six reviews reporting on 230 unique studies were included. Almost all reviews operationalized polypharmacy as medication count, and few examined medication classes or disease states within this. Evidence for an association between polypharmacy and many adverse outcomes, including adverse drug events and disability, was conflicting. The most consistent evidence was found for hospitalization and inappropriate prescribing. No research had explored polypharmacy in the very old (aged ≥85 years), or examined the potential social consequences associated with medication use, such as loneliness and isolation. Conclusions and implications The literature examining the adverse outcomes of polypharmacy in older people is complex, extensive, and conflicting. Until polypharmacy is operationalized in a more clinically relevant manner, the adverse outcomes associated with it will not be fully understood. Future studies should work toward this approach in the face of rising multimorbidity and population aging.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019 AMDA e The Society for Post-Acute and Long-Term Care Medicine. |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) |
Depositing User: | Pure (York) |
Date Deposited: | 19 Oct 2020 11:10 |
Last Modified: | 25 Feb 2025 00:06 |
Published Version: | https://doi.org/10.1016/j.jamda.2019.10.022 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1016/j.jamda.2019.10.022 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:166855 |