Evidence map›Paper›PMID 40817322›Full record

ArticleSystematic reviews2025

Understanding the challenges of medicine optimisation among older people (aged 60 years and above) from ethnic minority communities with polypharmacy in primary care: a realist review protocol.

Nesrein Hamed, Clare Bates, Muhammed Umair Khan, Ian Maidment

Abstract read
In one paragraph

Article in Systematic reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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.

Nesrein HamedAston University, Birmingham, United Kingdom. 160004825@aston.ac.uk.ORCID 0009-0001-4947-8692
Clare BatesNational Institute for Health and Care Research, London, United Kingdom.
Muhammed Umair KhanAston University, Birmingham, United Kingdom.
Ian MaidmentAston University, Birmingham, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcross many countries, the number of older people from ethnic minority communities is growing due to ageing populations and migration trends. In England and Wales, the population of older people from ethnic minority communities, particularly those aged 60 and above, is also increasing. This demographic change, often accompanied by the prevalence of polypharmacy in these communities, presents unique challenges in the context of medicine optimisation. Failure in this context can lead to exacerbated health disparities, non-adherence, and inappropriate prescribing (whether over or under). Building on the MEMORABLE study exploring medication management in older people, this review aims to understand the complexities of medicine optimisation, exploring what works and does not work, when and under what circumstances for older people from ethnic minority communities. Key possible areas include cultural backgrounds, traditional beliefs, and systemic barriers that may influence medicine optimisation.

methodsThe review will follow the five-step realist approach that firstly establishes initial programme theories to highlight the expected context, mechanisms, and outcomes. Then a formal search for evidence will be conducted. The third step involves the selection and appraisal of studies screened by title, abstract/keywords and full text based on exclusion/inclusion criteria. Then data from these studies will be extracted, recorded, and coded. The final step will synthesise this information, to test, refine, and expand our initial programme theories and generate context-mechanism-outcome configurations to better understand medicine optimisation in these communities. DISCUSSION: This review will be conducted in line with the RAMESES reporting standards. By explaining what works, for whom, and in what contexts, the review will generate theory-informed insights into MO for older people from ethnic minority communities with polypharmacy in primary care. These findings can support the development of culturally responsive, person-centred interventions. Results will be shared through peer-reviewed publications and presentations at relevant national and international conferences. TRIAL REGISTRATION: Systematic review registration: PROSPERO CRD42023432204.

Indexed as

EthnicityMinority GroupsPolypharmacyPrimary Health CareAgedHumansMiddle AgedSystematic Reviews as TopicCultural competenceDeprescribingHealth disparitiesMedication managementMedication reviewMultimorbidityPerson-centred care

Identifiers

PMID40817322
PMCPMC12355808

What Socratic holds

Textmetadata
LicenceCC BY
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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.