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Interventions to address potentially inappropriate prescriptions and over-the-counter medication use among adults 65 years and older in primary care settings: protocol for a systematic review.
Syst Rev. 2022 10 20; 11(1):225.SR

Abstract

PURPOSE

To inform recommendations by the Canadian Task Force on Preventive Health Care on potentially inappropriate prescribing and over-the-counter (OTC) medication use among adults aged 65 years and older in primary care settings. This protocol outlines the planned scope and methods for a systematic review of the benefits and harms and acceptability of interventions to reduce potentially inappropriate prescriptions and OTC medication use.

METHODS

De novo systematic reviews will be conducted to synthesize the available evidence on (a) the benefits and harms of interventions to reduce potentially inappropriate prescriptions and OTC medications compared to no intervention, usual care, or non- or minimally active intervention among adults aged 65 years and older and (b) the acceptability of these interventions or attributes among patients. Outcomes of interest for the benefits and harms review are all-cause mortality, hospitalization, non-serious adverse drug reactions, quality of life, emergency department visits, injurious falls, medical visits, and the number of medications (and number of pills). Outcomes for the acceptability review are the preference for and relative importance of different interventions or their attributes. For the benefits and harms review, we will search MEDLINE, Embase, and Cochrane Central Register of Controlled Trials for randomized controlled trials. For the acceptability review, we will search MEDLINE, Embase, PsycInfo, Cochrane Central Register of Controlled Trials, and the NHS Economic Evaluation Database for experimental and observational studies with a comparator. Websites of relevant organizations, other grey literature sources, and reference lists of included studies and reviews will be searched. Title and abstract screening will be completed by two independent reviewers using the liberal accelerated approach. Full-text review, data extraction, risk of bias assessments, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) will be completed independently by two reviewers, with any disagreements resolved by consensus or by consulting with a third reviewer. The GRADE approach will be used to assess the certainty of the evidence for outcomes.

DISCUSSION

The results of this systematic review will be used by the Canadian Task Force on Preventive Health Care to inform their recommendation on potentially inappropriate prescribing and OTC medication use among adults aged 65 years and older.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO (KQ1: CRD42022302313; KQ2: CRD42022302324); Open Science Framework (https://osf.io/urj4b/).

Links

PMC Free PDF

Authors+Show Affiliations

Beck A
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. andrew.e.beck@outlook.com.
Persaud N
Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.
Tessier LA
Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Ontario, Canada.
Grad R
Department of Family Medicine, McGill University, Montreal, Quebec, Canada.
Kidd MR
College of Health & Medicine, The Australian National University, Canberra, Australia. Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Klarenbach S
Department of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Korownyk C
Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada.
Moore A
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
Thombs BD
Lady Davis Institute of the Jewish General Hospital and Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Mangin D
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada. Department of General Practice, University of Otago, Dunedin, New Zealand.
McCracken RK
Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.
McDonald EG
Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.
Sirois C
Faculty of Pharmacy, Laval University; Centre d'excellence sur le vieillissement de Québec, VITAM research Centre, Québec, Québec, Canada.
Kanji S
The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Molnar F
Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. Division of Geriatric Medicine, The Ottawa Hospital, The Ottawa Hospital Research Institute, Bruyere Research Institute, Ottawa, Ontario, Canada.
Nicholls SG
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Thavorn K
Independent Information Specialist, Ottawa, Ontario, Canada.
Bennett A
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Shaver N
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Skidmore B
Independent Information Specialist, Ottawa, Ontario, Canada.
Mitchelmore BR
Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Ontario, Canada.
Avey M
Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Ontario, Canada.
Rolland-Harris E
Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Ontario, Canada.
Little J
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Moher D
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

MeSH

HumansAdultInappropriate PrescribingQuality of LifeCanadaBiasPrimary Health CareSystematic Reviews as Topic

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

36266708

Citation

Beck, Andrew, et al. "Interventions to Address Potentially Inappropriate Prescriptions and Over-the-counter Medication Use Among Adults 65 Years and Older in Primary Care Settings: Protocol for a Systematic Review." Systematic Reviews, vol. 11, no. 1, 2022, p. 225.
Beck A, Persaud N, Tessier LA, et al. Interventions to address potentially inappropriate prescriptions and over-the-counter medication use among adults 65 years and older in primary care settings: protocol for a systematic review. Syst Rev. 2022;11(1):225.
Beck, A., Persaud, N., Tessier, L. A., Grad, R., Kidd, M. R., Klarenbach, S., Korownyk, C., Moore, A., Thombs, B. D., Mangin, D., McCracken, R. K., McDonald, E. G., Sirois, C., Kanji, S., Molnar, F., Nicholls, S. G., Thavorn, K., Bennett, A., Shaver, N., ... Moher, D. (2022). Interventions to address potentially inappropriate prescriptions and over-the-counter medication use among adults 65 years and older in primary care settings: protocol for a systematic review. Systematic Reviews, 11(1), 225. https://doi.org/10.1186/s13643-022-02044-w
Beck A, et al. Interventions to Address Potentially Inappropriate Prescriptions and Over-the-counter Medication Use Among Adults 65 Years and Older in Primary Care Settings: Protocol for a Systematic Review. Syst Rev. 2022 10 20;11(1):225. PubMed PMID: 36266708.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interventions to address potentially inappropriate prescriptions and over-the-counter medication use among adults 65 years and older in primary care settings: protocol for a systematic review. AU - Beck,Andrew, AU - Persaud,Navindra, AU - Tessier,Laure A, AU - Grad,Roland, AU - Kidd,Michael R, AU - Klarenbach,Scott, AU - Korownyk,Christina, AU - Moore,Ainsley, AU - Thombs,Brett D, AU - Mangin,Dee, AU - McCracken,Rita K, AU - McDonald,Emily G, AU - Sirois,Caroline, AU - Kanji,Salmaan, AU - Molnar,Frank, AU - Nicholls,Stuart G, AU - Thavorn,Kednapa, AU - Bennett,Alexandria, AU - Shaver,Nicole, AU - Skidmore,Becky, AU - Mitchelmore,Bradley R, AU - Avey,Marc, AU - Rolland-Harris,Elizabeth, AU - Little,Julian, AU - Moher,David, Y1 - 2022/10/20/ PY - 2021/11/19/received PY - 2022/08/01/accepted PY - 2022/10/21/entrez PY - 2022/10/22/pubmed PY - 2022/10/25/medline KW - Guideline KW - Inappropriate prescribing KW - Older adults KW - Over-the-counter medication KW - Polypharmacy KW - Primary health care KW - Systematic review SP - 225 EP - 225 JF - Systematic reviews JO - Syst Rev VL - 11 IS - 1 N2 - PURPOSE: To inform recommendations by the Canadian Task Force on Preventive Health Care on potentially inappropriate prescribing and over-the-counter (OTC) medication use among adults aged 65 years and older in primary care settings. This protocol outlines the planned scope and methods for a systematic review of the benefits and harms and acceptability of interventions to reduce potentially inappropriate prescriptions and OTC medication use. METHODS: De novo systematic reviews will be conducted to synthesize the available evidence on (a) the benefits and harms of interventions to reduce potentially inappropriate prescriptions and OTC medications compared to no intervention, usual care, or non- or minimally active intervention among adults aged 65 years and older and (b) the acceptability of these interventions or attributes among patients. Outcomes of interest for the benefits and harms review are all-cause mortality, hospitalization, non-serious adverse drug reactions, quality of life, emergency department visits, injurious falls, medical visits, and the number of medications (and number of pills). Outcomes for the acceptability review are the preference for and relative importance of different interventions or their attributes. For the benefits and harms review, we will search MEDLINE, Embase, and Cochrane Central Register of Controlled Trials for randomized controlled trials. For the acceptability review, we will search MEDLINE, Embase, PsycInfo, Cochrane Central Register of Controlled Trials, and the NHS Economic Evaluation Database for experimental and observational studies with a comparator. Websites of relevant organizations, other grey literature sources, and reference lists of included studies and reviews will be searched. Title and abstract screening will be completed by two independent reviewers using the liberal accelerated approach. Full-text review, data extraction, risk of bias assessments, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) will be completed independently by two reviewers, with any disagreements resolved by consensus or by consulting with a third reviewer. The GRADE approach will be used to assess the certainty of the evidence for outcomes. DISCUSSION: The results of this systematic review will be used by the Canadian Task Force on Preventive Health Care to inform their recommendation on potentially inappropriate prescribing and OTC medication use among adults aged 65 years and older. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (KQ1: CRD42022302313; KQ2: CRD42022302324); Open Science Framework (https://osf.io/urj4b/). SN - 2046-4053 UR - https://www.unboundmedicine.com/medline/citation/36266708/Interventions_to_address_potentially_inappropriate_prescriptions_and_over_the_counter_medication_use_among_adults_65_years_and_older_in_primary_care_settings:_protocol_for_a_systematic_review_ DB - PRIME DP - Unbound Medicine ER -