A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set

Beuscart, JB; Pont, LG; Thevelin, S; Boland, B; Dalleur, O; Rutjes, AWS; Westbrook, JI; Spinewine, A

A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set

Beuscart, JB Pont, LG

Thevelin, S Boland, B Dalleur, O Rutjes, AWS Westbrook, JI Spinewine, A

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Publication Type:: Journal Article
Citation:: British Journal of Clinical Pharmacology, 2017, 83 (5), pp. 942 - 952
Issue Date:: 2017-01-01

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Field	Value	Language
dc.contributor.author	Beuscart, JB	en_US
dc.contributor.author	Pont, LG https://orcid.org/0000-0002-8545-716X	en_US
dc.contributor.author	Thevelin, S	en_US
dc.contributor.author	Boland, B	en_US
dc.contributor.author	Dalleur, O	en_US
dc.contributor.author	Rutjes, AWS	en_US
dc.contributor.author	Westbrook, JI	en_US
dc.contributor.author	Spinewine, A	en_US
dc.date.available	2016-11-22	en_US
dc.date.issued	2017-01-01	en_US
dc.identifier.citation	British Journal of Clinical Pharmacology, 2017, 83 (5), pp. 942 - 952	en_US
dc.identifier.issn	0306-5251	en_US
dc.identifier.uri	http://hdl.handle.net/10453/123354
dc.description.abstract	© 2016 The British Pharmacological Society Aim: Medication review has been advocated as one of the measures to tackle the challenge of polypharmacy in older patients, yet there is no consensus on how best to evaluate its efficacy. This study aimed to assess outcome reporting in trials of medication review in older patients. Methods: Randomized controlled trials (RCTs), prospective studies and RCT protocols involving medication review performed in patients aged 65 years or older in any setting of care were identified from: (1) a recent systematic review; (2) RCT registries of ongoing studies; (3) the Cochrane library. The type, definition, and frequency of all outcomes reported were extracted independently by two researchers. Results: Forty-seven RCTs or prospective published studies and 32 RCT protocols were identified. A total of 327 distinct outcomes were identified in the 47 published studies. Only one fifth (21%) of the studies evaluated the impact of medication reviews on adverse events such as drug reactions or drug-related hospital admissions. Most of the outcomes were related to medication use (n = 114, 35%) and healthcare use (n = 74, 23%). Very few outcomes were patient-related (n = 24, 7%). A total of 248 distinct outcomes were identified in the 32 RCT protocols. Overall, the number of outcomes and the number and type of health domains covered by the outcomes varied largely. Conclusion: Outcome reporting from RCTs concerning medication review in older patients is heterogeneous. This review highlights the need for a standardized core outcome set for medication review in older patients, to improve outcome reporting and evidence synthesis.	en_US
dc.relation.ispartof	British Journal of Clinical Pharmacology	en_US
dc.relation.isbasedon	10.1111/bcp.13197	en_US
dc.subject.classification	Pharmacology & Pharmacy	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Polypharmacy	en_US
dc.subject.mesh	Research Design	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Drug-Related Side Effects and Adverse Reactions	en_US
dc.subject.mesh	Medication Therapy Management	en_US
dc.subject.mesh	Outcome Assessment, Health Care	en_US
dc.subject.mesh	Randomized Controlled Trials as Topic	en_US
dc.title	A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set	en_US
dc.type	Journal Article
utslib.citation.volume	5	en_US
utslib.citation.volume	83	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	5	en_US
pubs.publication-status	Published	en_US
pubs.volume	83	en_US

Abstract:

© 2016 The British Pharmacological Society Aim: Medication review has been advocated as one of the measures to tackle the challenge of polypharmacy in older patients, yet there is no consensus on how best to evaluate its efficacy. This study aimed to assess outcome reporting in trials of medication review in older patients. Methods: Randomized controlled trials (RCTs), prospective studies and RCT protocols involving medication review performed in patients aged 65 years or older in any setting of care were identified from: (1) a recent systematic review; (2) RCT registries of ongoing studies; (3) the Cochrane library. The type, definition, and frequency of all outcomes reported were extracted independently by two researchers. Results: Forty-seven RCTs or prospective published studies and 32 RCT protocols were identified. A total of 327 distinct outcomes were identified in the 47 published studies. Only one fifth (21%) of the studies evaluated the impact of medication reviews on adverse events such as drug reactions or drug-related hospital admissions. Most of the outcomes were related to medication use (n = 114, 35%) and healthcare use (n = 74, 23%). Very few outcomes were patient-related (n = 24, 7%). A total of 248 distinct outcomes were identified in the 32 RCT protocols. Overall, the number of outcomes and the number and type of health domains covered by the outcomes varied largely. Conclusion: Outcome reporting from RCTs concerning medication review in older patients is heterogeneous. This review highlights the need for a standardized core outcome set for medication review in older patients, to improve outcome reporting and evidence synthesis.

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http://hdl.handle.net/10453/123354