Evidence map›Paper›PMID 36934249›Full record

SynthesisBMC geriatrics2023

Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis.

Anum Iqbal, Charlotte Richardson, Zain Iqbal, Hannah O'Keefe, Barbara Hanratty, Fiona E Matthews, Adam Todd

Open access · goldFull text readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC geriatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
7.0field-weighted citation impact, top 2% 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

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.

  1. Pooled it
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  7. Review
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  14. Review
  15. Patterns of medication use following breast cancer diagnosis: an Australian population-based study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  16. Medication Purchases Are Associated With the Number of Dental Treatments.Clinical and experimental dental research · 2025
    Article
  17. Article
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  19. Polypharmacy Is Associated With Slow Gait Speed and Recurrent Falls in Older People With HIV.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024
    Article
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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

7 authors at 2 institutions in 3 countries.

Anum IqbalSchool of Pharmacy, Population Health Sciences Institute, Newcastle University, King George VI Building, King's Road, Newcastle Upon Tyne, NE1 7RU, England. a.iqbal3@newcastle.ac.uk.
Charlotte RichardsonSchool of Pharmacy, Newcastle University, Newcastle Upon Tyne, England.
Zain IqbalNovartis International, Basel, Switzerland.
Hannah O'KeefePopulation Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, England.
Barbara HanrattyFaculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, England.
Fiona E MatthewsFaculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, England.
Adam ToddSchool of Pharmacy, Newcastle University, Newcastle Upon Tyne, England.
Newcastle University · GBNovartis (Switzerland) · CH

Funding

Department of Health
6 · The paper itself

Abstract

backgroundSocioeconomic status (SES) may influence prescribing, concordance and adherence to medication regimens. This review set out to investigate the association between polypharmacy and an individual's socioeconomic status.

methodsA systematic review and meta-analyses of observational studies was conducted across four databases. Older people (≥ 55 years) from any healthcare setting and residing location were included. The search was conducted across four databases: Medline (OVID), Web of Science, Embase (OVID) and CINAHL. Observational studies from 1990 that reported polypharmacy according to SES were included. A random-effects model was undertaken comparing those with polypharmacy (≥ 5 medication usage) with no polypharmacy. Unadjusted odds ratios (ORs), 95% confidence intervals (CIs) and standard errors (SE) were calculated for each study.

resultsFifty-four articles from 13,412 hits screened met the inclusion criteria. The measure of SES used were education (50 studies), income (18 studies), wealth (6 studies), occupation (4 studies), employment (7 studies), social class (5 studies), SES categories (2 studies) and deprivation (1 study). Thirteen studies were excluded from the meta-analysis. Lower SES was associated with higher polypharmacy usage: individuals of lower educational backgrounds displayed 21% higher odds to be in receipt of polypharmacy when compared to those of higher education backgrounds. Similar findings were shown for occupation, income, social class, and socioeconomic categories.

conclusionsThere are socioeconomic inequalities in polypharmacy among older people, with people of lower SES significantly having higher odds of polypharmacy. Future work could examine the reasons for these inequalities and explore the interplay between polypharmacy and multimorbidity.

Indexed as

IncomeSocial ClassAgedEducational StatusHumansOccupationsPolypharmacySocioeconomic FactorsAgeingHealth InequalitiesMedication UsageMeta-analysisPolypharmacySocioeconomic Status

Identifiers

PMID36934249
PMCPMC10024437
OpenAlexW4327813959

What Socratic holds

Textfull text, public
LicenceCC BY
measurements read23
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.