A systematic review of case-series studies on the effectiveness of interventions to reduce polypharmacy and its adverse consequences in the elderly.

Background. Aging is frequently accompanied by chronic diseases; as a consequence, older people are often exposed to polypharmacy that has been associated with negative health-consequences. The aim of this study is to conduct a systematic review of the literature reporting on the effectiveness of di...

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Main Authors: Maria Benedetta Michelazzo, Sonja Milovanovic, Stefania Boccia
Format: Article
Language:English
Published: Milano University Press 2017-03-01
Series:Epidemiology, Biostatistics and Public Health
Online Access:http://ebph.it/article/view/12148
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author Maria Benedetta Michelazzo
Sonja Milovanovic
Stefania Boccia
author_facet Maria Benedetta Michelazzo
Sonja Milovanovic
Stefania Boccia
author_sort Maria Benedetta Michelazzo
collection DOAJ
description Background. Aging is frequently accompanied by chronic diseases; as a consequence, older people are often exposed to polypharmacy that has been associated with negative health-consequences. The aim of this study is to conduct a systematic review of the literature reporting on the effectiveness of different approaches to reduce polypharmacy in the elderly. Methods. We conducted a comprehensive literature search of MEDLINE, Scopus and ISI Web of Knowledge databases. Eligible studies were case-series reporting outcomes of interventions aimed at reducing polypharmacy and its consequences in the elderly. A quality appraisal of the studies included was performed. Results. Nineteen studies were included, of which six conducted in community setting, seven in hospital setting, and six in nursing homes. Seventeen of them were judged as moderate quality, and two of them as poor quality. The majority of the interventions were carried out by pharmacists, alone (35%) or with other professionals (40%). Interventions consisted in pharmacotherapy reviews based on various tools and software; in some cases educational interventions were performed for review-performers and patients. Studies conducted in community-setting provided also a feedback to primary care physician. The outcomes included five categories: therapy’s characteristics (e.g. number of drugs, appropriate prescriptions), quality of life, health-related outcomes, costs, healthcare services’ utilization. Therapy-related outcomes were those more affected by all types of interventions. Conclusion. Interventions aimed at reviewing patients’ therapy are effective in optimizing the use of drugs, and could be considered also  in improving quality of life, healthcare costs, services’ utilization, and health-related outcomes.
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spelling doaj-art-1b4ea7c7e96b44d0b5746ee69cc75f042025-08-20T03:17:47ZengMilano University PressEpidemiology, Biostatistics and Public Health2282-09302017-03-0114110.2427/1214810812A systematic review of case-series studies on the effectiveness of interventions to reduce polypharmacy and its adverse consequences in the elderly.Maria Benedetta Michelazzo0Sonja Milovanovic1Stefania Boccia2Section of Hygiene, Department of Public Health, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, ItalySection of Hygiene - Institute of Public Health; Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario “Agostino Gemelli”, Rome, ItalySection of Hygiene - Institute of Public Health; Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario “Agostino Gemelli”, Rome, Italy Icahn School of Medicine at Mount Sinai, New York, NY, USABackground. Aging is frequently accompanied by chronic diseases; as a consequence, older people are often exposed to polypharmacy that has been associated with negative health-consequences. The aim of this study is to conduct a systematic review of the literature reporting on the effectiveness of different approaches to reduce polypharmacy in the elderly. Methods. We conducted a comprehensive literature search of MEDLINE, Scopus and ISI Web of Knowledge databases. Eligible studies were case-series reporting outcomes of interventions aimed at reducing polypharmacy and its consequences in the elderly. A quality appraisal of the studies included was performed. Results. Nineteen studies were included, of which six conducted in community setting, seven in hospital setting, and six in nursing homes. Seventeen of them were judged as moderate quality, and two of them as poor quality. The majority of the interventions were carried out by pharmacists, alone (35%) or with other professionals (40%). Interventions consisted in pharmacotherapy reviews based on various tools and software; in some cases educational interventions were performed for review-performers and patients. Studies conducted in community-setting provided also a feedback to primary care physician. The outcomes included five categories: therapy’s characteristics (e.g. number of drugs, appropriate prescriptions), quality of life, health-related outcomes, costs, healthcare services’ utilization. Therapy-related outcomes were those more affected by all types of interventions. Conclusion. Interventions aimed at reviewing patients’ therapy are effective in optimizing the use of drugs, and could be considered also  in improving quality of life, healthcare costs, services’ utilization, and health-related outcomes.http://ebph.it/article/view/12148
spellingShingle Maria Benedetta Michelazzo
Sonja Milovanovic
Stefania Boccia
A systematic review of case-series studies on the effectiveness of interventions to reduce polypharmacy and its adverse consequences in the elderly.
Epidemiology, Biostatistics and Public Health
title A systematic review of case-series studies on the effectiveness of interventions to reduce polypharmacy and its adverse consequences in the elderly.
title_full A systematic review of case-series studies on the effectiveness of interventions to reduce polypharmacy and its adverse consequences in the elderly.
title_fullStr A systematic review of case-series studies on the effectiveness of interventions to reduce polypharmacy and its adverse consequences in the elderly.
title_full_unstemmed A systematic review of case-series studies on the effectiveness of interventions to reduce polypharmacy and its adverse consequences in the elderly.
title_short A systematic review of case-series studies on the effectiveness of interventions to reduce polypharmacy and its adverse consequences in the elderly.
title_sort systematic review of case series studies on the effectiveness of interventions to reduce polypharmacy and its adverse consequences in the elderly
url http://ebph.it/article/view/12148
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