Evidence map›Paper›PMID 32641005›Full record

SynthesisBMC geriatrics2020

Optimisation of medications used in residential aged care facilities: a systematic review and meta-analysis of randomised controlled trials.

Hend Almutairi, Andrew Stafford, Christopher Etherton-Beer, Leon Flicker

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC geriatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 9 pooled it
3.8field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 9 syntheses or guidelines pooled it, 78 citations in OpenAlex.

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  2. Interventions for preventing falls in older people in care facilities.The Cochrane database of systematic reviews · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Hend AlmutairiMedical school, University of Western Australia, Perth, Australia. phhend@hotmail.com.ORCID 0000-0003-1326-6943
Andrew StaffordMedical school, University of Western Australia, Perth, Australia.
Christopher Etherton-BeerSchool of Medicine and Pharmacology, Western Australian Centre for Health and Ageing, University of Western Australia , Perth, Australia.
Leon FlickerMedical School, University of Western Australia, Western Australian Centre for Health and Ageing University of Western Australia, Perth, Australia.
The University of Western Australia · AU

Funding

Medical Research Future Fund Next Generation Clinical Researchers Practitioner Fellowship 1155669University of Western Australia International Fee Scholarship (Uifs) And University Postgraduate Award (Upa). 2019
6 · The paper itself

Abstract

backgroundFrail older adults living in residential aged care facilities (RACFs) usually experience comorbidities and are frequently prescribed multiple medications. This increases the potential risk of inappropriate prescribing and its negative consequences. Thus, optimising prescribed medications in RACFs is a challenge for healthcare providers.

objectiveOur aim was to systematically review interventions that increase the appropriateness of medications used in RACFs and the outcomes of these interventions.

methodsSystematic review and meta-analysis of randomised control trials (RCTs) and cluster randomised control trials (cRCTs) were performed by searching specified databases (MEDLINE, PubMed, Google scholar, PsycINFO) for publications from inception to May 2019 based on defined inclusion criteria. Data were extracted, study quality was assessed and statistically analysed using RevMan v5.3. Medication appropriateness, hospital admissions, mortality, falls, quality of life (QoL), Behavioural and Psychological Symptoms of Dementia (BPSD), adverse drug events (ADEs) and cognitive function could be meta-analysed.

resultsA total of 25 RCTs and cRCTs comprising 19,576 participants met the inclusion criteria. The studies tested various interventions including medication review (n = 13), staff education (n = 9), multi-disciplinary case conferencing (n = 4) and computerised clinical decision support systems (n = 2). There was an effect of interventions on medication appropriateness (RR 0.71; 95% confidence interval (CI): 0.60,0.84) (10 studies), and on medication appropriateness scales (standardised mean difference = - 0.67; 95% CI: - 0.97, - 0.36) (2 studies). There were no apparent effects on hospital admission (RR 1.00; 95% CI: 0.93, 1.06), mortality (RR 0.98; 95% CI: 0.86, 1.11), falls (RR 1.06; 95% CI: 0.89,1.26), ADEs (RR 1.04; 95% CI: 0.96,1.13), QoL (standardised mean difference = 0.16; 95% CI:-0.13, 0.45), cognitive function (weighted mean difference = 0.69; 95% CI: - 1.25, 2.64) and BPSD (RR 0.68; 95% CI: 0.44,1.06) (2 studies).

conclusionModest improvements in medication appropriateness were observed in the studies included in this systematic review. However, the effect on clinical measures was limited to drive strong conclusions.

Indexed as

Assisted Living FacilitiesDrug-Related Side Effects and Adverse ReactionsMedication ReviewAccidental FallsAgedFrail ElderlyHospitalizationHumansRandomized Controlled Trials as TopicAged care facilityClinical outcomesElderlyInterventionMedication optimisationMeta-analysisSystematic review

Identifiers

PMID32641005
PMCPMC7346508
OpenAlexW3040923873

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.