In:
Journal of the American Geriatrics Society, Wiley, Vol. 62, No. 12 ( 2014-12), p. 2261-2272
Abstract:
To summarize evidence regarding the health outcomes associated with polypharmacy, defined as number of prescribed medications, in older community‐dwelling persons. Design Systematic review of MEDLINE (Ovid SP 1946 to May, Week 3, 2014). Setting Community. Participants Observational studies examining health outcomes according to number of prescription medications taken. Measurements Association between number of medications and health outcomes. Because of the importance of comorbidity as a potential confounder of the relationship between polypharmacy and health outcomes, articles were assessed regarding the quality of their adjustment for confounding. Results Of the 50 studies identified, the majority that were rated good in terms of their adjustment for comorbidity demonstrated relationships between polypharmacy and a range of outcomes, including falls, fall outcomes, fall risk factors, adverse drug events, hospitalization, mortality, and measures of function and cognition. However, a number of these studies failed to demonstrate associations, as did a substantial proportion of studies rated fair or poor. Conclusion Data are mixed regarding the relationship between polypharmacy, considered in terms of number of medications, and adverse outcomes in community‐dwelling older persons. Because of the challenge of confounding, randomized controlled trials of medication discontinuation may provide more‐definitive evidence regarding this relationship than observational studies can provide.
Type of Medium:
Online Resource
ISSN:
0002-8614
,
1532-5415
DOI:
10.1111/jgs.2014.62.issue-12
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2040494-3
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