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Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis

AIMS: To synthesise associations of potentially inappropriate prescribing (PIP) with health‐related and system‐related outcomes in inpatient hospital settings. METHODS: Six electronic databases were searched: Medline Complete, EMBASE, CINAHL, PyscInfo, IPA and Cochrane library. Studies published bet...

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Autores principales: Mekonnen, Alemayehu B, Redley, Bernice, de Courten, Barbora, Manias, Elizabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597090/
https://www.ncbi.nlm.nih.gov/pubmed/34008195
http://dx.doi.org/10.1111/bcp.14870
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author Mekonnen, Alemayehu B
Redley, Bernice
de Courten, Barbora
Manias, Elizabeth
author_facet Mekonnen, Alemayehu B
Redley, Bernice
de Courten, Barbora
Manias, Elizabeth
author_sort Mekonnen, Alemayehu B
collection PubMed
description AIMS: To synthesise associations of potentially inappropriate prescribing (PIP) with health‐related and system‐related outcomes in inpatient hospital settings. METHODS: Six electronic databases were searched: Medline Complete, EMBASE, CINAHL, PyscInfo, IPA and Cochrane library. Studies published between 1 January 1991 and 31 January 2021 investigating associations between PIP and health‐related and system‐related outcomes of older adults in hospital settings, were included. A random effects model was employed using the generic inverse variance method to pool risk estimates. RESULTS: Overall, 63 studies were included. Pooled risk estimates did not show a significant association with all‐cause mortality (adjusted odds ratio [AOR] 1.10, 95% confidence interval [CI] 0.90–1.36; adjusted hazard ratio 1.02, 83% CI 0.90–1.16), and hospital readmission (AOR 1.11, 95% CI 0.76–1.63; adjusted hazard ratio 1.02, 95% CI 0.89–1.18). PIP was associated with 91%, 60% and 26% increased odds of adverse drug event‐related hospital admissions (AOR 1.91, 95% CI 1.21–3.01), functional decline (AOR 1.60, 95% CI 1.28–2.01), and adverse drug reactions and adverse drug events (AOR 1.26, 95% CI 1.11–1.43), respectively. PIP was associated with falls (2/2 studies). The impact of PIP on emergency department visits, length of stay, and health‐related quality of life was inconclusive. Economic cost of PIP reported in 3 studies, comprised various cost estimation methods. CONCLUSIONS: PIP was significantly associated with a range of health‐related and system‐related outcomes. It is important to optimise older adults' prescriptions to facilitate improved outcomes of care.
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spelling pubmed-85970902021-11-22 Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis Mekonnen, Alemayehu B Redley, Bernice de Courten, Barbora Manias, Elizabeth Br J Clin Pharmacol Systematic Review and Meta‐analysis AIMS: To synthesise associations of potentially inappropriate prescribing (PIP) with health‐related and system‐related outcomes in inpatient hospital settings. METHODS: Six electronic databases were searched: Medline Complete, EMBASE, CINAHL, PyscInfo, IPA and Cochrane library. Studies published between 1 January 1991 and 31 January 2021 investigating associations between PIP and health‐related and system‐related outcomes of older adults in hospital settings, were included. A random effects model was employed using the generic inverse variance method to pool risk estimates. RESULTS: Overall, 63 studies were included. Pooled risk estimates did not show a significant association with all‐cause mortality (adjusted odds ratio [AOR] 1.10, 95% confidence interval [CI] 0.90–1.36; adjusted hazard ratio 1.02, 83% CI 0.90–1.16), and hospital readmission (AOR 1.11, 95% CI 0.76–1.63; adjusted hazard ratio 1.02, 95% CI 0.89–1.18). PIP was associated with 91%, 60% and 26% increased odds of adverse drug event‐related hospital admissions (AOR 1.91, 95% CI 1.21–3.01), functional decline (AOR 1.60, 95% CI 1.28–2.01), and adverse drug reactions and adverse drug events (AOR 1.26, 95% CI 1.11–1.43), respectively. PIP was associated with falls (2/2 studies). The impact of PIP on emergency department visits, length of stay, and health‐related quality of life was inconclusive. Economic cost of PIP reported in 3 studies, comprised various cost estimation methods. CONCLUSIONS: PIP was significantly associated with a range of health‐related and system‐related outcomes. It is important to optimise older adults' prescriptions to facilitate improved outcomes of care. John Wiley and Sons Inc. 2021-05-18 2021-11 /pmc/articles/PMC8597090/ /pubmed/34008195 http://dx.doi.org/10.1111/bcp.14870 Text en © 2021 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Systematic Review and Meta‐analysis
Mekonnen, Alemayehu B
Redley, Bernice
de Courten, Barbora
Manias, Elizabeth
Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis
title Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis
title_full Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis
title_fullStr Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis
title_full_unstemmed Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis
title_short Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis
title_sort potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: a systematic review and meta‐analysis
topic Systematic Review and Meta‐analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597090/
https://www.ncbi.nlm.nih.gov/pubmed/34008195
http://dx.doi.org/10.1111/bcp.14870
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