SynthesisBMC geriatrics2025
Realist review: understanding the challenges of medicine optimisation among older people from ethnic minority communities with polypharmacy in primary care.
Synthesis in BMC geriatrics, 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.
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.
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.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPolypharmacy is growing among older people from ethnic minority communities in the United Kingdom, due to a higher prevalence of chronic conditions like diabetes and cardiovascular diseases. Health disparities and unequal access to healthcare services further complicate treatment. Medicine optimisation aims to identify suboptimal medication use, reduce unnecessary medications, and improve adherence. However, medicine optimisation within ethnic minority communities presents challenges because of cultural differences, language barriers, and systemic issues. AIMS AND
objectivesTo understand how Medicine optimisation works (or does not work) for older people from ethnic minority communities within primary care, identifying what works, for whom, and under what circumstances.
methodsWe conducted a realist review following Pawson’s five-step framework: we developed initial programme theories, conducted systematic searches, selected and appraised studies, and synthesised the data. The review adhered to the Realist and Meta-Narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines. RESULT/DISCUSSION: Our programme theory is supported by 11 context-mechanism-outcome configurations that outline key contextual factors and mechanisms influencing the outcomes of Medicine optimisation. Cultural competence among practitioners is essential for building trust. Cultural norms and stigmas significantly influence how medications are perceived and adhered to, while language barriers hinder effective communication and understanding between older people and practitioners. Additionally, religious beliefs shape health behaviours and can impact adherence.
conclusionMedicine optimisation for older people from ethnic minority communities is complex, due to the layered context in which Medicine optimisation occurs. Our review suggests that one-size-fits-all approaches to Medicine optimisation are inadequate. Significant gaps remain in understanding the contexts and mechanisms affecting Medicine optimisation in these groups, requiring further research across.
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What Socratic holds
Registered trials
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.