Medication reviews and deprescribing as a single intervention in falls prevention: a systematic review and meta-analysis
| العنوان: | Medication reviews and deprescribing as a single intervention in falls prevention: a systematic review and meta-analysis |
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| المؤلفون: | Seppala, Lotta J., Kamkar, Nellie, van Poelgeest, Eveline P., Thomsen, Katja, Daams, Joost G., Ryg, Jesper, Masud, Tahir, Montero-Odasso, Manuel, Hartikainen, Sirpa, Petrovic, Mirko, van der Velde, Nathalie, Nieuwboer, Alice, Vlaeyen, Ellen, Milisen, Koen, Kenny, Rose Anne, Bourke, Robert, van der Cammen, Tischa, Poelgeest, Eveline, Jellema, Anton, Todd, Chris, Martin, Finbarr C., Marsh, David R., Lamb, Sallie, Frith, James, Logan, Pip, Skelton, Dawn, Blain, Hubert, Anweiller, Cedric, Freiberger, Ellen, Becker, Clemens, Chiari, Lorenzo, Cesari, Matteo, Casas-Herrero, Alvaro, Perez Jara, Javier, Alonzo Bouzòn, Christina, Welmer, Ana-Karim, Birnghebuam, Stephanie, Kressig, Reto, Speechley, Mark, Mcilroy, Bill, Faria, Frederico, Sultana, Munira, Muir-Hunter, Susan, Camicioli, Richard, Madden, Kenneth, Norris, Mireille, Watt, Jennifer, Mallet, Louise, Hogan, David, Verghese, Joe, Sejdic, Ervin, Ferruci, Luigi, Lipsitz, Lewis, Ganz, David A., Alexander, Neil B., Latham, Nancy Kathryn, Giber, Fabiana, Schapira, Marcelo, Jauregui, Ricardo, Melgar-Cuellar, Felipe, Alves Lourenço, Roberto, Carvalho de Abreu, Daniela Cristina, Perracini, Monica, Ceriani, Alejandro, Marín-Larraín, Pedro, Espinola, Homero Gac, Gómez-Montes, Jose Fernando, Cano-Gutierrez, Carlos Alberto, Ulate, Xinia Ramirez, Picado Ovares, Jose Ernesto, Gabriel Buendia, Patricio, Tito, Susana Lucia, Padilla, Diego Martínez, Aguilar-Navarro, Sara G., Mimenza, Alberto, Moctezum, Rogelio, Avila-Funes, Alberto, Gutierrez-Robledo, Luis Miguel, Cornejo Alemán, Luis Manuel, Caona, Edgar Aguilera, Carbajal, Juan Carlos, Parodi, Jose F., Sgaravatti, Aldo, Lord, Stephen, Sherrington, Cathie, Said, Cathy, Cameron, Ian, Morris, Meg, Duque, Gustavo, Close, Jacqueline, Kerse, Ngaire, Tan, Maw Pin, Duan, Leilei, Sakurai, Ryota, Wong, Chek Hooi, Muneeb, Irfan, Negahban, Hossein, Birimoglu, Canan, Won, Chang Won, Huasdorff, Jeffrey, Kalula, Sebastiana, Kobusingye, Olive |
| المساهمون: | Geriatrics, APH - Aging & Later Life, Medical Library, AMS - Ageing & Vitality |
| المصدر: | AGE AND AGEING Age and ageing, 51(9):afac191. Oxford University Press Age and Ageing, 51(9) |
| بيانات النشر: | Oxford University Press (OUP), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Aging, Medication Review, General Medicine, Hospitals, fall-risk-increasing drugs, older people, Deprescriptions, deprescribing, systematic review, Medicine and Health Sciences, Humans, accidental falls, medication review, Geriatrics and Gerontology, Exercise |
| الوصف: | Background our aim was to assess the effectiveness of medication review and deprescribing interventions as a single intervention in falls prevention. Methods Design systematic review and meta-analysis. Data sources Medline, Embase, Cochrane CENTRAL, PsycINFO until 28 March 2022. Eligibility criteria randomised controlled trials of older participants comparing any medication review or deprescribing intervention with usual care and reporting falls as an outcome. Study records title/abstract and full-text screening by two reviewers. Risk of bias Cochrane Collaboration revised tool. Data synthesis results reported separately for different settings and sufficiently comparable studies meta-analysed. Results forty-nine heterogeneous studies were included. Community meta-analyses of medication reviews resulted in a risk ratio (RR) of 1.05 (95% confidence interval, 0.85–1.29, I2 = 0%, 3 studies(s)) for number of fallers, in an RR = 0.95 (0.70–1.27, I2 = 37%, 3 s) for number of injurious fallers and in a rate ratio (RaR) of 0.89 (0.69–1.14, I2 = 0%, 2 s) for injurious falls. Hospital meta-analyses assessing medication reviews resulted in an RR = 0.97 (0.74–1.28, I2 = 15%, 2 s) and in an RR = 0.50 (0.07–3.50, I2 = 72% %, 2 s) for number of fallers after and during admission, respectively. Long-term care meta-analyses investigating medication reviews or deprescribing plans resulted in an RR = 0.86 (0.72–1.02, I2 = 0%, 5 s) for number of fallers and in an RaR = 0.93 (0.64–1.35, I2 = 92%, 7 s) for number of falls. Conclusions the heterogeneity of the interventions precluded us to estimate the exact effect of medication review and deprescribing as a single intervention. For future studies, more comparability is warranted. These interventions should not be implemented as a stand-alone strategy in falls prevention but included in multimodal strategies due to the multifactorial nature of falls. PROSPERO registration number: CRD42020218231 |
| وصف الملف: | application/pdf |
| تدمد: | 1468-2834 0002-0729 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9e0b7c6a1e00d17ebeaf21b4d3383610Test https://doi.org/10.1093/ageing/afac191Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9e0b7c6a1e00d17ebeaf21b4d3383610 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14682834 00020729 |
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