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Interventions to address potentially inappropriate prescribing in community-dwelling older adults: a systematic review of randomized controlled trials (2016)

Clyne, Barbara; Fitzgerald, Ciaran; Quinlan, Aisling; Hardy, Colin; Galvin, Rose; Fahey...

Interventions to address potentially inappropriate prescribing in community-dwelling older adults: a systematic review of randomized controlled trials (2016)

Clyne, Barbara; Fitzgerald, Ciaran; Quinlan, Aisling; Hardy, Colin; Galvin, Rose; Fahey, Tom; Smith, Susan M.

Abstract:

OBJECTIVES: To perform a systematic review to determine the effectiveness of interventions designed to reduce potentially inappropriate prescribing (PIP) in community-dwelling older adults.DESIGN: Systematic review and narrative synthesis.SETTING: Primary and community care.PARTICIPANTS: Community-dwelling older adults.MEASUREMENTS: The primary outcome was change in PIP measured using implicit or explicit tools. Studies were grouped into organizational, professional, financial, regulatory, and multifaceted interventions.RESULTS: Twelve randomized controlled trials were identified with baseline PIP prevalence of 18% to 100%. Four of six organizational interventions reported a reduction in PIP, particularly through pharmacists conducting medication reviews. Evidence of the effectiveness of multi-disciplinary teams was weak. Both of the two professional (targeting prescriber's directly) interventions were computerized clinical decision support interventions and were effective in d...

http://hdl.handle.net/10344/6094

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Interventions to Address Potentially Inappropriate Prescribing in Community-Dwelling Older Adults: A Systematic Review of Randomized Controlled Trials. (2016)

Clyne, Barbara; Fitzgerald, Ciaran; Quinlan, Aisling; Hardy, Colin; Galvin, Rose; Fahey...

Interventions to Address Potentially Inappropriate Prescribing in Community-Dwelling Older Adults: A Systematic Review of Randomized Controlled Trials. (2016)

Clyne, Barbara; Fitzgerald, Ciaran; Quinlan, Aisling; Hardy, Colin; Galvin, Rose; Fahey, Tom; Smith, Susan M

Abstract:

This is the peer reviewed version of the following article: Clyne B, Fitzgerald C, Quinlan A, Hardy C, Galvin R, Fahey T, Smith SM. Interventions to Address Potentially Inappropriate Prescribing in Community-Dwelling Older Adults: A Systematic Review of Randomized Controlled Trials. Journal of the American Geriatrics Society. 2016;64(6):1210-22, which has been published in final form at <a>doi: 10.1111/jgs.14133</a>. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
OBJECTIVES: To perform a systematic review to determine the effectiveness of interventions designed to reduce potentially inappropriate prescribing (PIP) in community-dwelling older adults. DESIGN: Systematic review and narrative synthesis. SETTING: Primary and community care. PARTICIPANTS: Community-dwelling older adults. MEASUREMENTS...

https://epubs.rcsi.ie/gpart/101

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Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta- analysis (2014)

Barry, Emma; Galvin, Rose; Keogh, Claire; Horgan, Frances N.; Fahey, Tom

Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta- analysis (2014)

Barry, Emma; Galvin, Rose; Keogh, Claire; Horgan, Frances N.; Fahey, Tom

Abstract:

Background: The Timed Up and Go test (TUG) is a commonly used screening tool to assist clinicians to identify patients at risk of falling. The purpose of this systematic review and meta-analysis is to determine the overall predictive value of the TUG in community-dwelling older adults. Methods: A literature search was performed to identify all studies that validated the TUG test. The methodological quality of the selected studies was assessed using the QUADAS-2 tool, a validated tool for the quality assessment of diagnostic accuracy studies. A TUG score of ≥13.5 seconds was used to identify individuals at higher risk of falling. All included studies were combined using a bivariate random effects model to generate pooled estimates of sensitivity and specificity at ≥13.5 seconds. Heterogeneity was assessed using the variance of logit transformed sensitivity and specificity. Results: Twenty-five studies were included in the systematic review and 10 studies were included in meta-analysi...

http://hdl.handle.net/10344/4758

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Predicting adverse health outcomes in older community-dwelling adults: a prospective cohort study (2016)

Wallace, Emma

Predicting adverse health outcomes in older community-dwelling adults: a prospective cohort study (2016)

Wallace, Emma

Abstract:

Background This thesis aimed to investigate if adverse health outcomes in older community-dwelling people can be predicted, through the application of measures of prescribing, multimorbidity and emergency admission risk models. There were five objectives: 1) to determine if there is a longitudinal association between potentially inappropriate prescribing (PIP) and future adverse drug events (ADEs), reduced health related quality of life (HRQOL) and increased use of Accident & Emergency (A&E) and emergency admissions; 2) to assess the performance of different measures of multimorbidity and vulnerability in predicting emergency hospital attendance and functional decline; 3) to conduct a systematic review of emergency admission risk prediction models developed for use in community-dwelling adults; 4) to systematically review and meta-analyse the validation studies of the Probability of repeated admissions (Pra) risk model...

https://epubs.rcsi.ie/phdtheses/175

Displaying Results 1 - 4 of 4 on page 1 of 1