Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations

Detalhes bibliográficos
Autor(a) principal: Soler, Orenzio
Data de Publicação: 2019
Outros Autores: Barreto, Jorge Otávio Maia
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/41599
Resumo: DIREB 017 FIO 16 (Fiocruz / Ministério da Saúde)
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spelling Soler, OrenzioBarreto, Jorge Otávio Maia2020-06-10T12:07:15Z2020-06-10T12:07:15Z2019SOLER, Orenzio; BARRETO, Jorge Otávio Maia. Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations. Frontiers in Pharmacology, [Lausanne], v. 10, n. 302, p. 1-10, Apr. 2019.1663-9812https://www.arca.fiocruz.br/handle/icict/4159910.3389/fphar.2019.00302DIREB 017 FIO 16 (Fiocruz / Ministério da Saúde)Universidade Federal do Pará. Instituto de Ciências da Saúde. Faculdade de Farmácia. Belém, PA, Brasil.Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.Background: Patients over 65 years of age taking multiple medications face several risks, and pharmaceutical interventions can be useful to improve quality of care and reduce those risks. However, there is still no consensus on the effectiveness of these interventions aimed at promoting changes in clinical, epidemiological, economic, and humanistic outcomes for various service delivery, organizational, financial, and implementation-based interventions. The objective of this overview of systematic reviews was to summarize evidence on the effectiveness of community-level pharmaceutical interventions to reduce the risks associated with polypharmacy in the population over 65 years of age. Method: This overview used a previously described protocol to search for systematic review articles, with and without meta-analysis, and economic evaluations, without any language or time restrictions, including articles published up to May 2018. The following databases were searched: the Cochrane Library, Epistemonikos, Health Evidence, Health Systems Evidence, Virtual Health Library, and Google Scholar. The basic search terms used were "elderly," "polypharmacy," and "pharmaceutical interventions." The findings for outcomes of interest were categorized using a taxonomy for health policies and systems. Equity-related questions were also investigated. The studies were evaluated for methodological quality and produced a narrative synthesis. Results: A total of 642 records were retrieved: 50 from Health Evidence, 197 from Epistemonikos, 194 from Cochrane, 116 from Health Systems Evidence, and 85 from the Virtual Health Library. Of these, 16 articles were selected: 1 overview of systematic reviews, 12 systematic reviews, and 3 economic evaluations. There is evidence of improvement in clinical, epidemiological, humanistic, and economic outcomes for various types of community-level pharmaceutical interventions, but differences in observed outcomes may be due to study designs, primary study sample sizes, risk of bias, difficulty in aggregating data, heterogeneity of indicators and quality of evidence included in the systematic reviews that were assessed. It is necessary to optimize the methodological designs of future primary and secondary studies. Conclusion: Community-level pharmaceutical interventions can improve various clinical, epidemiological, humanistic and economic outcomes and potentially reduce risks associated with polypharmacy in the elderly population.engFrontiers MediaAgedPolypharmacyDrug CombinationsElderlyOverviewPharmaceutical interventionsPolypharmacySystematic reviewIdosoPolimedicaçãoCombinação de MedicamentosRevisão SistemáticaCommunity-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluationsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; 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dc.title.pt_BR.fl_str_mv Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations
title Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations
spellingShingle Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations
Soler, Orenzio
Aged
Polypharmacy
Drug Combinations
Elderly
Overview
Pharmaceutical interventions
Polypharmacy
Systematic review
Idoso
Polimedicação
Combinação de Medicamentos
Revisão Sistemática
title_short Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations
title_full Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations
title_fullStr Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations
title_full_unstemmed Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations
title_sort Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations
author Soler, Orenzio
author_facet Soler, Orenzio
Barreto, Jorge Otávio Maia
author_role author
author2 Barreto, Jorge Otávio Maia
author2_role author
dc.contributor.author.fl_str_mv Soler, Orenzio
Barreto, Jorge Otávio Maia
dc.subject.mesh.pt_BR.fl_str_mv Aged
Polypharmacy
Drug Combinations
topic Aged
Polypharmacy
Drug Combinations
Elderly
Overview
Pharmaceutical interventions
Polypharmacy
Systematic review
Idoso
Polimedicação
Combinação de Medicamentos
Revisão Sistemática
dc.subject.en.pt_BR.fl_str_mv Elderly
Overview
Pharmaceutical interventions
Polypharmacy
Systematic review
dc.subject.decs.pt_BR.fl_str_mv Idoso
Polimedicação
Combinação de Medicamentos
Revisão Sistemática
description DIREB 017 FIO 16 (Fiocruz / Ministério da Saúde)
publishDate 2019
dc.date.issued.fl_str_mv 2019
dc.date.accessioned.fl_str_mv 2020-06-10T12:07:15Z
dc.date.available.fl_str_mv 2020-06-10T12:07:15Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.citation.fl_str_mv SOLER, Orenzio; BARRETO, Jorge Otávio Maia. Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations. Frontiers in Pharmacology, [Lausanne], v. 10, n. 302, p. 1-10, Apr. 2019.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/41599
dc.identifier.issn.pt_BR.fl_str_mv 1663-9812
dc.identifier.doi.none.fl_str_mv 10.3389/fphar.2019.00302
identifier_str_mv SOLER, Orenzio; BARRETO, Jorge Otávio Maia. Community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations. Frontiers in Pharmacology, [Lausanne], v. 10, n. 302, p. 1-10, Apr. 2019.
1663-9812
10.3389/fphar.2019.00302
url https://www.arca.fiocruz.br/handle/icict/41599
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Frontiers Media
publisher.none.fl_str_mv Frontiers Media
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
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repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv repositorio.arca@fiocruz.br
_version_ 1813008995219144704

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