MEDICATION REVIEW IN PREVENTING FALL-RELATED INJURIES IN OLDER ADULTS-A SYSTEMATIC REVIEW AND META-ANALYSIS. (16th November 2018)

• Record Type: Journal Article
• Authors: Ming, Y; Zecevic, A; Hunter, S; Miao, W; Tirona, R
• Is Part Of: Innovation in aging. Volume 2(2018)Supplement 1
• Page Start: 983
• Page End: 983
• Publication Date: 2018-11-16
• Subjects: Aging -- Periodicals; Gerontology -- Periodicals; 612.67
• DOI: 10.1093/geroni/igy031.3638
• Languages: English
• ISSNs: 2399-5300

Abstract

Abstract: Background: Medication use is considered a modifiable risk factor for falls and fall-related injuries in older adults. Hence, medication review is essential in managing adverse drug reactions, facilitating appropriate prescribing and improving drug safety in older adults. This systematic review summarized information on the effectiveness of medication review as a single intervention or in combination with other interventions in preventing fall-related injuries in older adults. Methods: Electronic databases search was conducted in PubMed, EMBASE, Scopus and CINAHL. Two reviewers screened titles and abstracts, reviewed full-texts, performed data extraction and risk of bias assessment. Meta-analyses were conducted on studies with similar participants, interventions, outcomes or settings. Results: Fourteen randomized, controlled studies were included in this review. Seven studies were of low risk of bias. Four studies evaluated medication review as a single intervention. The pooled result indicated that medication review as a stand-alone intervention was effective in preventing fall-related injuries in community-dwelling older adults (Risk Difference (RD)=-0.06, 95%CI (-0.11 to -0.00), I2=61%, P=0.04). Meta-analysis conducted on five studies with fractures due to falls as the outcomes also showed that medication review had a positive impact on decreasing the risk of fall-related fractures (RD= -0.02, 95%CI (-0.04 to -0.01), I2=0%, P=0.01). Discussion: This systematic review and meta-analysis has demonstrated that medication review is effective in preventing fall-related injuries in general and fractures specifically in community-dwelling older adults. Future investigations focusing on details of performing medication review will further inform improving the health of older adults.