| アブストラクト | BACKGROUND: Medication reviews are considered an opportunity for reducing polypharmacy. However, there is little evidence about their impact in a real-world setting. AIM: To quantify numbers of older adults having a medication review in 2019, identify systematic differences in access to medication reviews, and assess the impact of medication reviews on the numbers of medicines prescribed. METHOD: We defined a population of people aged >/=65 years with at least one active prescription on 01/01/2019 using anonymised electronic health records from the Clinical Practice Research Datalink. We used Cox regression to compare characteristics of people who did and did not have a medication review recorded in their health records in 2019. We compared the maximum number of concurrent prescriptions ('polypharmacy count') in the 3 months before and after a recorded medication review. RESULTS: Of 591 552 people (median age = 74 years, 54.5% female), 305 503 (51.6%) had a medication review in 2019. Living in a care home (hazard ratio [HR] 1.51, 95% confidence interval [CI] =1.40 to 1.62), a prior medication review in 2018 (HR 1.83, 95% CI = 1.69 to 1.98), and increasing baseline polypharmacy count (5-9 medicines versus 1 medicine HR 1.41, 95% CI = 1.37 to 1.46) were most strongly associated with having a review. Overall, there was a small mean increase in polypharmacy count after a review (+0.13 medicines, 0.12-0.14). For people prescribed >/=10 medicines before the review, polypharmacy count decreased on average (mean -0.14 medicines, -0.15 to -0.12). CONCLUSION: Although a majority (>50%) of people had a recorded medication review in 2019, these reviews had a small overall impact on polypharmacy in this study population. |
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| ジャーナル名 | The British journal of general practice : the journal of the Royal College of General Practitioners |
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| 投稿日 | 2023/7/22 |
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| 投稿者 | Joseph, Rebecca; Knaggs, Roger; Coupland, Carol; Taylor, Amy; Vinogradova, Yana; Butler, Debbie; Waldram, David; Iyen, Barbara; Akyea, Ralph; Ashcroft, Darren; Avery, Anthony; Jack, Ruth |
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| 組織名 | University of Nottingham.;University of Manchester. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37479307/ |
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