The outcomes of considering goals of care in medication reviews for older adults: a systematic review.
Expert Rev Clin Pharmacol
; 17(1): 33-56, 2024 Jan.
Article
em En
| MEDLINE
| ID: mdl-38145414
ABSTRACT
INTRODUCTION:
This is a systematic review of prescribing, clinical, patient-reported, and health utilization outcomes of goal-directed medication reviews in older adults.METHODS:
A systematic review was conducted using MEDLINE, EMBASE, SCOPUS and CINAHL databases to identify studies examining outcomes of goal-directed medication reviews in humans, with mean/median age ≥ 60 years and in English.RESULTS:
Seventeen out of 743 articles identified were included. Whilst there were inconsistent findings regarding changes in the number of medications between groups or post-intervention in one group (n = 6 studies), studies found reductions in drug-related problems (n = 2) and potential to reduce anticholinergics and sedatives (n = 2). Two out of seven studies investigating clinical outcomes found improvements, such as reduced hospital readmissions and improved depression severity. One study found 75% of patients achieved ≥ 1 goals and another found 43% of goals were achieved at six months. Four out of five studies found significant improvements in patient-reported quality of life between groups (n = 2) or post-intervention in one group (n = 2). Both studies investigating cost-effectiveness reported the intervention was cost-effective.CONCLUSIONS:
There is evidence of positive impact on medication rationalization, quality of life and cost-effectiveness, supporting goal-directed medication reviews. Larger, longitudinal studies, exploring patient-focused outcomes may provide further insights into the ongoing impact of goal-directed medication reviews.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Planejamento de Assistência ao Paciente
/
Revisão de Medicamentos
Tipo de estudo:
Systematic_reviews
Limite:
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
Expert Rev Clin Pharmacol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Austrália