Please use this identifier to cite or link to this item: https://doi.org/10.1177/20420986211030371
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dc.titleInappropriate medications and physical function: a systematic review
dc.contributor.authorManias, Elizabeth
dc.contributor.authorKabir, Md Zunayed
dc.contributor.authorMaier, Andrea B
dc.date.accessioned2022-11-28T12:28:27Z
dc.date.available2022-11-28T12:28:27Z
dc.date.issued2021-07-01
dc.identifier.citationManias, Elizabeth, Kabir, Md Zunayed, Maier, Andrea B (2021-07-01). Inappropriate medications and physical function: a systematic review. THERAPEUTIC ADVANCES IN DRUG SAFETY 12. ScholarBank@NUS Repository. https://doi.org/10.1177/20420986211030371
dc.identifier.issn2042-0986
dc.identifier.issn2042-0994
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/234877
dc.description.abstractBackground and aims: Inappropriate medication prescription is highly prevalent in older adults and is associated with adverse health outcomes. The aim of this study was to examine the associations between potentially inappropriate medications (PIMS) and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: A systematic search was completed using the following databases: MEDLINE, CINAHL, PsycINFO, EMBASE and COCHRANE. Results were extracted from the included studies. Results: In total, 55 studies reported on 2,767,594 participants with a mean age of 77.1 years (63.5% women). Study designs comprised 26 retrospective cohort studies, 21 prospective cohort studies and 8 cross-sectional studies. Inappropriate medications in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), impaired activities of daily living (ADL; 8 out of 10 studies) and impaired instrumental ADL (IADL) score (4 out of 6 studies). Five out of seven studies also showed that PIMs were associated with poorer physical performance comprising the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many medication classes were implicated as PIMs in falls, fractures and impairment in physical performance including antipsychotic, sedative, anti-anxiety, anticholinergic, antidiabetic, opioid and antihypertensive medications. For patients not receiving musculoskeletal medications, such as calcium, vitamin D and bisphosphonates, older adults were found to be at risk of a hospital admission for a fall or fracture. Conclusion: Inappropriate medication prescriptions are associated with impaired physical function across longitudinal and cross-sectional studies in older adults situated in diverse settings. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions. Plain language summary: Inappropriate medications and physical function Background and aims: The use of inappropriate medications is very common in older adults and is associated with harmful health problems. The aim was to examine associations between potentially inappropriate medications and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: Library databases were examined for possible studies to include and a systematic search was completed. Relevant information was obtained from the included studies. Results: In total, 55 studies reported on 2,767,594 participants who were an average age of 77.1 years and about 6 out of 10 were women. A variety of different study designs were used. Inappropriate medication prescriptions in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), problems with activities of daily living (ADL), such as eating, bathing, dressing, grooming, walking and toileting (8 out of 10 studies) and problems with instrumental ADL such as managing medications, house cleaning and shopping (4 out of 6 studies). Five out of seven studies also showed that inappropriate medications were associated with poorer physical performance involving the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many types of medication classes were shown to be associated with a risk of falls, fractures and problems with physical performance. Omitted medications were also associated with falls and fractures. Conclusion: Inappropriate medication prescriptions are associated with problems relating to physical function. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions.
dc.language.isoen
dc.publisherSAGE PUBLICATIONS LTD
dc.sourceElements
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectPharmacology & Pharmacy
dc.subjectactivities of daily living
dc.subjectaged
dc.subjectfunctional independence
dc.subjectindependent living
dc.subjectmedication therapy management
dc.subjectphysical function
dc.subjectOLDER PERSONS
dc.subjectDRUG-USE
dc.subjectANTICHOLINERGIC BURDEN
dc.subjectHEALTH OUTCOMES
dc.subjectBEERS CRITERIA
dc.subjectGERIATRIC-PATIENTS
dc.subjectELDERLY-PEOPLE
dc.subjectADULTS
dc.subjectPOPULATION
dc.subjectPREVALENCE
dc.typeArticle
dc.date.updated2022-11-28T09:08:57Z
dc.contributor.departmentDEPT OF MEDICINE
dc.description.doi10.1177/20420986211030371
dc.description.sourcetitleTHERAPEUTIC ADVANCES IN DRUG SAFETY
dc.description.volume12
dc.published.statePublished
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