Andrew Beck1, Navindra Persaud2, Laure A Tessier3, Roland Grad4, Michael R Kidd5,6, Scott Klarenbach7, Christina Korownyk8, Ainsley Moore9, Brett D Thombs10, Dee Mangin9,11, Rita K McCracken12, Emily G McDonald13, Caroline Sirois14, Salmaan Kanji15, Frank Molnar16,17, Stuart G Nicholls18, Kednapa Thavorn19, Alexandria Bennett20, Nicole Shaver20, Becky Skidmore19, Bradley R Mitchelmore3, Marc Avey3, Elizabeth Rolland-Harris3, Julian Little20, David Moher20. 1. School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. andrew.e.beck@outlook.com. 2. Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada. 3. Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Ontario, Canada. 4. Department of Family Medicine, McGill University, Montreal, Quebec, Canada. 5. College of Health & Medicine, The Australian National University, Canberra, Australia. 6. Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada. 7. Department of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. 8. Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada. 9. Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada. 10. Lady Davis Institute of the Jewish General Hospital and Faculty of Medicine, McGill University, Montreal, Quebec, Canada. 11. Department of General Practice, University of Otago, Dunedin, New Zealand. 12. Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada. 13. Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada. 14. Faculty of Pharmacy, Laval University; Centre d'excellence sur le vieillissement de Québec, VITAM research Centre, Québec, Québec, Canada. 15. The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. 16. Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. 17. Division of Geriatric Medicine, The Ottawa Hospital, The Ottawa Hospital Research Institute, Bruyere Research Institute, Ottawa, Ontario, Canada. 18. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. 19. Independent Information Specialist, Ottawa, Ontario, Canada. 20. School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Abstract
PURPOSE: To inform recommendations by the Canadian Task Force on Preventive Health Care on potentially inappropriate prescribing and over-the-counter (OTC) medication use among adults aged 65 years and older in primary care settings. This protocol outlines the planned scope and methods for a systematic review of the benefits and harms and acceptability of interventions to reduce potentially inappropriate prescriptions and OTC medication use. METHODS: De novo systematic reviews will be conducted to synthesize the available evidence on (a) the benefits and harms of interventions to reduce potentially inappropriate prescriptions and OTC medications compared to no intervention, usual care, or non- or minimally active intervention among adults aged 65 years and older and (b) the acceptability of these interventions or attributes among patients. Outcomes of interest for the benefits and harms review are all-cause mortality, hospitalization, non-serious adverse drug reactions, quality of life, emergency department visits, injurious falls, medical visits, and the number of medications (and number of pills). Outcomes for the acceptability review are the preference for and relative importance of different interventions or their attributes. For the benefits and harms review, we will search MEDLINE, Embase, and Cochrane Central Register of Controlled Trials for randomized controlled trials. For the acceptability review, we will search MEDLINE, Embase, PsycInfo, Cochrane Central Register of Controlled Trials, and the NHS Economic Evaluation Database for experimental and observational studies with a comparator. Websites of relevant organizations, other grey literature sources, and reference lists of included studies and reviews will be searched. Title and abstract screening will be completed by two independent reviewers using the liberal accelerated approach. Full-text review, data extraction, risk of bias assessments, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) will be completed independently by two reviewers, with any disagreements resolved by consensus or by consulting with a third reviewer. The GRADE approach will be used to assess the certainty of the evidence for outcomes. DISCUSSION: The results of this systematic review will be used by the Canadian Task Force on Preventive Health Care to inform their recommendation on potentially inappropriate prescribing and OTC medication use among adults aged 65 years and older. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (KQ1: CRD42022302313; KQ2: CRD42022302324); Open Science Framework ( https://osf.io/urj4b/ ).
PURPOSE: To inform recommendations by the Canadian Task Force on Preventive Health Care on potentially inappropriate prescribing and over-the-counter (OTC) medication use among adults aged 65 years and older in primary care settings. This protocol outlines the planned scope and methods for a systematic review of the benefits and harms and acceptability of interventions to reduce potentially inappropriate prescriptions and OTC medication use. METHODS: De novo systematic reviews will be conducted to synthesize the available evidence on (a) the benefits and harms of interventions to reduce potentially inappropriate prescriptions and OTC medications compared to no intervention, usual care, or non- or minimally active intervention among adults aged 65 years and older and (b) the acceptability of these interventions or attributes among patients. Outcomes of interest for the benefits and harms review are all-cause mortality, hospitalization, non-serious adverse drug reactions, quality of life, emergency department visits, injurious falls, medical visits, and the number of medications (and number of pills). Outcomes for the acceptability review are the preference for and relative importance of different interventions or their attributes. For the benefits and harms review, we will search MEDLINE, Embase, and Cochrane Central Register of Controlled Trials for randomized controlled trials. For the acceptability review, we will search MEDLINE, Embase, PsycInfo, Cochrane Central Register of Controlled Trials, and the NHS Economic Evaluation Database for experimental and observational studies with a comparator. Websites of relevant organizations, other grey literature sources, and reference lists of included studies and reviews will be searched. Title and abstract screening will be completed by two independent reviewers using the liberal accelerated approach. Full-text review, data extraction, risk of bias assessments, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) will be completed independently by two reviewers, with any disagreements resolved by consensus or by consulting with a third reviewer. The GRADE approach will be used to assess the certainty of the evidence for outcomes. DISCUSSION: The results of this systematic review will be used by the Canadian Task Force on Preventive Health Care to inform their recommendation on potentially inappropriate prescribing and OTC medication use among adults aged 65 years and older. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (KQ1: CRD42022302313; KQ2: CRD42022302324); Open Science Framework ( https://osf.io/urj4b/ ).
Authors: David Atkins; Dana Best; Peter A Briss; Martin Eccles; Yngve Falck-Ytter; Signe Flottorp; Gordon H Guyatt; Robin T Harbour; Margaret C Haugh; David Henry; Suzanne Hill; Roman Jaeschke; Gillian Leng; Alessandro Liberati; Nicola Magrini; James Mason; Philippa Middleton; Jacek Mrukowicz; Dianne O'Connell; Andrew D Oxman; Bob Phillips; Holger J Schünemann; Tessa Tan-Torres Edejer; Helena Varonen; Gunn E Vist; John W Williams; Stephanie Zaza Journal: BMJ Date: 2004-06-19
Authors: Miranda Cumpston; Tianjing Li; Matthew J Page; Jacqueline Chandler; Vivian A Welch; Julian Pt Higgins; James Thomas Journal: Cochrane Database Syst Rev Date: 2019-10-03
Authors: Amy T Page; Rhonda M Clifford; Kathleen Potter; Darren Schwartz; Christopher D Etherton-Beer Journal: Br J Clin Pharmacol Date: 2016-06-13 Impact factor: 4.335
Authors: Larissa Shamseer; David Moher; Mike Clarke; Davina Ghersi; Alessandro Liberati; Mark Petticrew; Paul Shekelle; Lesley A Stewart Journal: BMJ Date: 2015-01-02
Authors: Karen A Robinson; Evelyn P Whitlock; Maya E Oneil; Johanna K Anderson; Lisa Hartling; Donna M Dryden; Mary Butler; Sydne J Newberry; Melissa McPheeters; Nancy D Berkman; Jennifer S Lin; Stephanie Chang Journal: Syst Rev Date: 2014-06-23