Premium
Meta‐analysis of Interventions to Reduce Adverse Drug Reactions in Older Adults
Author(s) -
Gray Shelly L.,
Hart Laura A.,
Perera Subashan,
Semla Todd P.,
Schmader Kenneth E.,
Hanlon Joseph T.
Publication year - 2018
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.15195
Subject(s) - medicine , psychological intervention , randomized controlled trial , cochrane library , odds ratio , confidence interval , meta analysis , medline , adverse effect , pharmacist , family medicine , pharmacy , psychiatry , political science , law
Objectives To examine the effect of interventions to optimize medication use on adverse drug reactions ( ADR s) in older adults. Design Systematic review and meta‐analysis. EMBASE , PubMed, OVID , Cochrane Library, Clinicaltrials.gov, and Google Scholar were searched through April 30, 2017. Setting Randomized controlled trials. Participants Older adults (mean age ≥65) taking medications. Measurements Two authors independently extracted relevant information and assessed studies for risk of bias. Discrepancies were resolved in consensus meetings. The outcomes were any and serious ADR s. Random‐effects models were used to combine the results of multiple studies and create summary estimates. Results Thirteen randomized controlled trials involving 6,198 older adults were included. The studies employed a number of different interventions that were categorized as pharmacist‐led interventions (8 studies), other health professional‐led interventions (3 studies), a brief educational session (1 study), and a technology intervention (1 study). The intervention group was 21% less likely than the control group to experience any ADR (odds ratio ( OR ) = 0.79, 95% confidence interval ( CI ) = 0.62–0.99). In the six studies that examined serious ADR s, the intervention group was 36% less likely than the control group to experience a serious ADR ( OR = 0.64, 95% CI = 0.42–0.98). Conclusion Interventions designed to optimize medication use reduced the risk of any and serious ADR s in older adults. Implementation of these successful interventions in healthcare systems may improve medication safety in older adults.