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A set of systematic reviews to help reduce inappropriate prescribing to older people: study protocol

Overview of attention for article published in BMC Geriatrics, October 2017
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2 tweeters

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13 Dimensions

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Title
A set of systematic reviews to help reduce inappropriate prescribing to older people: study protocol
Published in
BMC Geriatrics, October 2017
DOI 10.1186/s12877-017-0570-9
Pubmed ID
Authors

Yolanda V. Martinez, Anna Renom-Guiteras, David Reeves, R. Erandie Ediriweera de Silva, Aneez Esmail, Ilkka Kunnamo, Anja Rieckert, Christina Sommerauer, Andreas Sönnichsen

Abstract

Multimorbidity and polypharmacy are common in older people. Assessment tools or lists of criteria aimed at supporting prescription decisions for older people exist, but have often been based on expert opinion with insufficient consideration of the evidence available. The present paper describes the methods we are using to systematically review the existing evidence on the efficacy and safety of the most commonly prescribed drugs for older people in the management of their chronic medical conditions and to develop recommendations to reduce inappropriate prescriptions for incorporation into the Comprehensive Medication Review (CMR) tool developed by the PRIMA-eDS European project. We selected the 20 most relevant drugs/drug classes in terms of prescription volumes and risk of hospitalisation for older people and the most relevant indications for the most common chronic conditions among older people and a total of 35 distinct drug-indication pairs were chosen. Based on clinical considerations we collapsed some indications together, reducing the 35 pairs to a final total of 22 separate systematic reviews (SR). A common methodology will be used for each individual SR, based on the methodological manuals of the Cochrane collaboration and the PRISMA statement for reporting systematic reviews. Our search strategy will have a staged approach where we initially search for systematic reviews and meta-analyses, but if relevant reviews are not found, then search for individual studies (controlled intervention and observational studies). Our pilot work and initial scoping of the literature suggested that very few, relevant individual trials or existing systematic reviews have researched or reported exclusively on older people. Therefore, sufficient data might not be available to perform meta-analysis but we will provide a narrative synthesis describing characteristics and findings of included studies. The collected evidence will be used to construct recommendations on when not to use or to discontinue a drug, or when to reduce its dose. Recommendations will be developed in team meetings using the GRADE methodology to reflect the strength of the recommendation and the quality of the evidence. Recommendations will be built into the CMR tool. This protocol has been prepared for a series of systematic reviews which will provide research-based evidence to develop recommendations to reduce inappropriate polypharmacy in older people as part of the CMR tool of the PRIMA-eDS project.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 67 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 67 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 11 16%
Student > Bachelor 10 15%
Student > Doctoral Student 7 10%
Student > Ph. D. Student 7 10%
Researcher 7 10%
Other 11 16%
Unknown 14 21%
Readers by discipline Count As %
Medicine and Dentistry 22 33%
Pharmacology, Toxicology and Pharmaceutical Science 9 13%
Nursing and Health Professions 7 10%
Psychology 4 6%
Social Sciences 3 4%
Other 6 9%
Unknown 16 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 January 2018.
All research outputs
#13,135,703
of 19,791,698 outputs
Outputs from BMC Geriatrics
#1,892
of 2,426 outputs
Outputs of similar age
#257,438
of 430,698 outputs
Outputs of similar age from BMC Geriatrics
#174
of 222 outputs
Altmetric has tracked 19,791,698 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,426 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.2. This one is in the 16th percentile – i.e., 16% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 430,698 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 222 others from the same source and published within six weeks on either side of this one. This one is in the 15th percentile – i.e., 15% of its contemporaries scored the same or lower than it.