Abstract | OBJECTIVES: To summarize evidence regarding the health outcomes associated with polypharmacy, defined as number of prescribed medications, in older community-dwelling persons. DESIGN: Systematic review of MEDLINE (OvidSP 1946 to May, Week 3, 2014). SETTING: Community. PARTICIPANTS: Observational studies examining health outcomes according to number of prescription medications taken. MEASUREMENTS: Association between number of medications and health outcomes. Because of the importance of comorbidity as a potential confounder of the relationship between polypharmacy and health outcomes, articles were assessed regarding the quality of their adjustment for confounding. RESULTS: Of the 50 studies identified, the majority that were rated good in terms of their adjustment for comorbidity demonstrated relationships between polypharmacy and a range of outcomes, including falls, fall outcomes, fall risk factors, adverse drug events, hospitalization, mortality, and measures of function and cognition. However, a number of these studies failed to demonstrate associations, as did a substantial proportion of studies rated fair or poor. CONCLUSION: Data are mixed regarding the relationship between polypharmacy, considered in terms of number of medications, and adverse outcomes in community-dwelling older persons. Because of the challenge of confounding, randomized controlled trials of medication discontinuation may provide more-definitive evidence regarding this relationship than observational studies can provide.
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Authors | Terri R Fried, John O'Leary, Virginia Towle, Mary K Goldstein, Mark Trentalange, Deanna K Martin |
Journal | Journal of the American Geriatrics Society
(J Am Geriatr Soc)
Vol. 62
Issue 12
Pg. 2261-72
(Dec 2014)
ISSN: 1532-5415 [Electronic] United States |
PMID | 25516023
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review, Systematic Review)
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Copyright | © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society. |
Chemical References |
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Topics |
- Accidental Falls
- Aged
- Aged, 80 and over
- Chronic Disease
(drug therapy)
- Comorbidity
- Drug-Related Side Effects and Adverse Reactions
- Geriatric Assessment
- Humans
- Polypharmacy
- Prescription Drugs
(administration & dosage, adverse effects)
- Risk Factors
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