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The risks and benefits of patients temporarily discontinuing medications in the event of an intercurrent illness: a systematic review protocol

Overview of attention for article published in Systematic Reviews, January 2015
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  • Above-average Attention Score compared to outputs of the same age (64th percentile)
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Mentioned by

twitter
4 tweeters

Citations

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9 Dimensions

Readers on

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41 Mendeley
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Title
The risks and benefits of patients temporarily discontinuing medications in the event of an intercurrent illness: a systematic review protocol
Published in
Systematic Reviews, January 2015
DOI 10.1186/s13643-015-0135-y
Pubmed ID
Authors

Andrew Morden, Jeremy Horwood, Penny Whiting, Jelena Savovic, Laurie Tomlinson, Thomas Blakeman, Charles Tomson, Alison Richards, Tracey Stone, Fergus Caskey

Abstract

Acute kidney injury (AKI) is common and often leads to significant morbidity and/or death. The development of AKI, or complications associated with it, may be due to use of certain medications in at-risk patients experiencing an intercurrent illness. Implicated drugs include diuretics, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/direct renin inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), metformin and sulfonylureas. Expert consensus opinion (and clinical guidelines) recommend considering discontinuation of diuretics, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/direct renin inhibitors, NSAIDs, metformin and sulfonylureas in the event of an intercurrent illness to prevent AKI onset or reduce severity or complications. However, the evidence base for these recommendations is very limited. This systematic review aims to address the available evidence for the temporary discontinuation of diuretics, ACE inhibitors, angiotensin receptor blockers, direct renin inhibitors, non-steroidal anti-inflammatories and metformin and sulfonylureas for those at risk of AKI or with newly diagnosed AKI. Randomised controlled trials; non-randomised trials; cohort studies; case-control studies; interrupted time series studies; and before-and-after studies featuring adults aged 18 and over in any setting currently taking diuretics, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/direct renin inhibitors, NSAIDs and metformin; experiencing an intercurrent illness; or undergoing a radiological/surgical procedure (planned or unplanned) will be searched for. Relevant trial registers and systematic review databases will be searched. Systematic reviews will be assessed for methodological quality using the ROBIS tool, trials will be assessed using the Cochrane risk of bias tool, and observational studies will be assessed using the ACROBAT-NRS tool. If sufficient studies assessing similar populations, study type, settings and outcomes are found, then a formal meta-analysis will be performed to estimate summary measures of effect. If not, a narrative synthesis will be adopted. This review will synthesise evidence for the efficacy of discontinuing diuretics, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/direct renin inhibitors, NSAIDs, metformin or sulfonylureas to prevent or delay onset of AKI or associated complications. Results will provide guidance on efficacy and safety of this strategy and potentially help to develop an intervention to test the best mechanism of guiding medication discontinuation in at-risk populations. PROSPERO CRD42015023210.

Twitter Demographics

The data shown below were collected from the profiles of 4 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 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 41 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 15%
Researcher 5 12%
Student > Bachelor 5 12%
Student > Doctoral Student 3 7%
Other 3 7%
Other 7 17%
Unknown 12 29%
Readers by discipline Count As %
Medicine and Dentistry 14 34%
Nursing and Health Professions 4 10%
Pharmacology, Toxicology and Pharmaceutical Science 3 7%
Economics, Econometrics and Finance 2 5%
Biochemistry, Genetics and Molecular Biology 1 2%
Other 4 10%
Unknown 13 32%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. 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 05 March 2017.
All research outputs
#6,164,684
of 12,106,553 outputs
Outputs from Systematic Reviews
#583
of 921 outputs
Outputs of similar age
#87,845
of 253,323 outputs
Outputs of similar age from Systematic Reviews
#30
of 50 outputs
Altmetric has tracked 12,106,553 research outputs across all sources so far. This one is in the 48th percentile – i.e., 48% of other outputs scored the same or lower than it.
So far Altmetric has tracked 921 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.4. This one is in the 36th percentile – i.e., 36% 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 253,323 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 64% of its contemporaries.
We're also able to compare this research output to 50 others from the same source and published within six weeks on either side of this one. This one is in the 40th percentile – i.e., 40% of its contemporaries scored the same or lower than it.