An overview of systematic reviews and meta-analyses on the effect of medication interventions targeting polypharmacy for frail older adults

Aparna Verma, Sanjib Saha, Johan Jarl, Ellen Conlon, Bernadette McGuinness, Dominic Trépel*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)
41 Downloads (Pure)

Abstract

Frailty refers to the lack of resilience and a reduction in a person’s ability to recover following a health problem, and it is increasingly becoming a challenging aspect of ageing populations. Many older adults are exposed to polypharmacy; i.e., they continue to be on medications without timely re-evaluation. Medication reviews have proven successful in managing polypharmacy in the general population, but there is uncertainty regarding their effect among frail older adults. This overview of published systematic reviews assesses the impact of medication reviews on polypharmacy in frail older adults. Embase was searched from its inception to January 2021 and 28 systematic reviews were identified, out of which 10 were included in the overview. Medication reviews were the most common intervention in 8 out of 10 systematic reviews. The frailty score was reported as an outcome in one systematic review that found no evidence for fundamental pharmacological effects on frailty. Six systematic reviews reported a statistically significant reduction in the number of inappropriately prescribed medications. Four systematic reviews reported on hospital admissions, with two of them reporting a decrease in hospitalisations. The quality assessment was moderate in six and critically low in four of the systematic reviews. We conclude that medication reviews help in reducing the use of inappropriate medications in frail older adults, but that there is insufficient evidence in terms of frailty score and hospital admissions.

Original languageEnglish
Article number1379
JournalJournal of Clinical Medicine
Volume12
Issue number4
DOIs
Publication statusPublished - 09 Feb 2023

Bibliographical note

Funding Information:
This research was funded by Public Health Agency (Northern Ireland) under A grant agreement entitled ‘Health Economic Partnership between Public Health Agency (Northern Ireland) and Trinity College Dublin’. Part of S.S.’s and J.J.’s time was funded by the Familjen Kamprads Stiftelse ref no 20210167.

Publisher Copyright:
© 2023 by the authors.

Keywords

  • frailty
  • medication interventions
  • polypharmacy

ASJC Scopus subject areas

  • General Medicine

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