Correction: Factors associated with potentially inappropriate prescriptions and barriers to medicines optimisation among older adults in primary care settings: a systematic review

ObjectiveTo identify factors that likely contribute to potentially inappropriate prescriptions (PIPs) among older adults in primary care settings, as well as barriers to medicines optimisation and recommended potential solutions.DesignSystematic review.Eligibility criteriaQuantitative studies that analysed the factors associated with PIPs among older adults (≥65 years) in primary care settings, and qualitative studies that explored perceived barriers and potential solutions to medicines optimisation for this population.Information sourcesPubMed, EMBASE, Scopus, CINAHL, PsycINFO, Web of Science, CNKI and Wanfang.ResultsOf the 13 167 studies identified, 50 were included (14 qualitative, 34 cross-sectional and 2 cohort). Nearly all quantitative studies examined patient-related non-clinical factors (eg, age) and clinical factors (eg, number of medications) and nine studies examined prescriber-related factors (eg, physician age). A greater number of medications were identified as positively associated with PIPs in 25 quantitative studies, and a higher number of comorbidities, physical comorbidities and psychiatric comorbidities were identified as patient-related clinical risk factors for PIPs. However, other factors showed inconsistent associations with the PIPs. Barriers to medicines optimisation emerged within four analytical themes: prescriber related (eg, inadequate knowledge, concerns of adverse consequences, clinical inertia, lack of communication), patient related (eg, limited understanding, patient non-adherence, drug dependency), environment related (eg, lack of integrated care, insufficient investment, time constraints) and technology related (eg, complexity of implementation and inapplicable guidance). Recommended potential solutions were based on each theme of the barriers identified accordingly (eg, prescriber-related factors: incorporating training courses into continuing medical education).ConclusionsOlder adults with more drugs prescribed and comorbidities may have a greater risk of receiving PIPs in the primary care setting, but it remains unclear whether other factors are related. Barriers to medicines optimisation among primary care older adults comprise multiple factors, and evidence-based and targeted interventions are needed to address these difficulties.PROSPERO registration numberCRD42020216258.

Download Full-text

The Effects Of Practice Size On Quality Of Care In Primary Care Settings: A Systematic Review

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/01938924-201210270-00001 ◽

2012 ◽

Vol 10 (27) ◽

pp. 1549-1633

Author(s):

Ng Kok Ping ◽

Ng Charis Wei Ling

Keyword(s):

Systematic Review ◽

Primary Care ◽

Quality Of Care ◽

Primary Care Settings ◽

Practice Size

Download Full-text

A Systematic Review of Individual, Psychological and Sociocultural Factors Associated with Safe and Risky Sexual Behavior in Older Adults

American Journal of Sexuality Education ◽

10.1080/15546128.2021.1904310 ◽

2021 ◽

pp. 1-20

Author(s):

Dafne Astrid Gómez Melasio ◽

Dora Julia Onofre Rodríguez ◽

Raquel Alicia Benavides Torres ◽

Pedro Enrique Trujillo Hernández

Keyword(s):

Systematic Review ◽

Older Adults ◽

Sexual Behavior ◽

Risky Sexual Behavior ◽

Sociocultural Factors ◽

Factors Associated

Download Full-text

Medicines Related Problems (MRPs) Originating in Primary Care Settings in Older Adults - A Systematic Review

Journal of Pharmacy Practice ◽

10.1177/08971900211023638 ◽

2021 ◽

pp. 089719002110236

Author(s):

Rosetta Chinyere Ude-Okeleke ◽

Zoe Aslanpour ◽

Soraya Dhillon ◽

Nkiruka Umaru

Keyword(s):

Systematic Review ◽

Primary Care ◽

Library Science ◽

Cochrane Library ◽

Inclusion Criteria ◽

Data Bases ◽

Primary Care Settings ◽

Preventative Interventions ◽

Use Of Health Services

Background: As people age, they become increasingly vulnerable to the untoward effects of medicines due to changes in body systems. These may result in medicines related problems (MRPs) and consequent decline or deterioration in health. Aim: To identify MRPs, indicators of deterioration associated with these MRPs, and preventative interventions from the literature. Design and Setting: Systematic review of primary studies on MRPs originating in Primary Care in older people. Methods: Relevant studies published between 2001 and April 2018 were obtained from Medline (via PubMed), CINAHL, Embase, Psych Info, PASCAL, Scopus, Cochrane Library, Science Direct, and Zetoc. Falls, delirium, pressure ulcer, hospitalization, use of health services and death were agreed indicators of deterioration. The methodological quality of included studies was assessed using the Down and Black tool. Results: There were 1858 articles retrieved from the data bases. Out of these, 21 full text articles met inclusion criteria for the review. MRPs identified were medication error, potentially inappropriate medicines, adverse drug reaction and non-adherence. These were associated with indicators of deterioration. Interventions that involved doctors, pharmacists and patients in planning and implementation yielded benefits in halting MRPs. Conclusion: This Systematic review summarizes MRPs and associated indicators of deterioration. Appropriate interventions appeared to be effective against certain MRPs and their consequences. Further studies to explore deterioration presented in this systematic review is imperative.

Download Full-text

Clinical Effectiveness of Family Therapeutic Interventions Embedded in General Pediatric Primary Care Settings for Parental Mental Health: A Systematic Review and Meta-analysis

Clinical Child and Family Psychology Review ◽

10.1007/s10567-015-0190-x ◽

2015 ◽

Vol 18 (4) ◽

pp. 395-412 ◽

Cited By ~ 8

Author(s):

Fallon Cluxton-Keller ◽

Anne W. Riley ◽

Sassan Noazin ◽

Mfon Valencia Umoren

Keyword(s):

Mental Health ◽

Systematic Review ◽

Primary Care ◽

Meta Analysis ◽

Clinical Effectiveness ◽

Therapeutic Interventions ◽

Pediatric Primary Care ◽

Parental Mental Health ◽

Primary Care Settings

Download Full-text

Prevalence and Factors Associated with Food Insecurity among Older Adults in Sub-Saharan Africa: A Systematic Review

Journal of Nutrition in Gerontology and Geriatrics ◽

10.1080/21551197.2021.1988027 ◽

2021 ◽

pp. 1-26

Author(s):

Sanjoy Saha ◽

Andrew Behnke ◽

Wilna Oldewage-Theron ◽

Noshin Mubtasim ◽

Makenzie Miller

Keyword(s):

Systematic Review ◽

Older Adults ◽

Food Insecurity ◽

Sub Saharan Africa ◽

Factors Associated ◽

Sub Saharan

Download Full-text

Persistence with oral bisphosphonates and denosumab among older adults in primary care in Ireland

10.1101/2020.10.05.20207290 ◽

2020 ◽

Author(s):

Mary E. Walsh ◽

Tom Fahey ◽

Frank Moriarty

Keyword(s):

Older Adults ◽

Primary Care ◽

Vitamin D ◽

Fracture Risk ◽

Bone Health ◽

Pharmacological Treatment ◽

Age Group ◽

Oral Bisphosphonates ◽

Factors Associated ◽

Increase Fracture Risk

ABSTRACTPurposeGaps in pharmacological treatment for osteoporosis can reduce effectiveness. This study aimed to estimate persistence rates for oral bisphosphonates and denosumab in older primary care patients and identify factors associated with discontinuation.MethodsOlder patients newly prescribed oral bisphosphonates or denosumab between 2012 and 2017 were identified from 44 general practices (GP) in Ireland. Persistence without a coverage gap of >90 days was calculated for both medications from therapy initiation. Factors associated with time to discontinuation were explored using Cox regression analysis. Exposures included age-group, osteoporosis diagnosis, fracture history, calcium/vitamin D prescription, number of other medications, health cover, dosing frequency (bisphosphonates) and previous bone-health medication (denosumab).ResultsOf 41,901 patients, n=1,569 newly initiated on oral bisphosphonates and n=1,615 on denosumab. Two-year persistence was 49.4% for oral bisphosphonates and 53.8% for denosumab and <10% were switched to other medication. Having state-funded health cover was associated with a lower hazard of discontinuation for both oral bisphosphonates (HR=0.49, 95%CI=0.36-0.66, p<0.01) and denosumab (HR=0.71, 95%CI=0.57-0.89, p<0.01). Older age-group, number of medications and calcium/vitamin D prescription were also associated with better bisphosphonate persistence while having osteoporosis diagnosed was associated with better denosumab persistence.ConclusionPersistence for osteoporosis medications is sub-optimal. Of concern, few patients are switched to other bone-health treatments when denosumab is stopped which could increase fracture risk. Free access to GP services and medications may have resulted in better medication persistence in this cohort. Future research should explore prescribing choices in primary-care osteoporosis management and evaluate cost-effectiveness of interventions for improving persistence.SUMMARYGaps in pharmacological treatment for osteoporosis can reduce its effectiveness. This study found approximately half of older adults in primary care newly initiated on bisphosphonates or denosumab were still taking these after 2 years. Abrupt discontinuation of denosumab without switching to an alternative is concerning due to increased fracture risk.

Download Full-text