TY  - JOUR
PY  - 2022//
TI  - Medication reviews and deprescribing as a single intervention in falls prevention: a systematic review and meta-analysis
JO  - Age and ageing
A1  - Hartikainen, Sirpa
A1  - Montero-Odasso, Manuel
A1  - Masud, Tahir
A1  - Ryg, Jesper
A1  - Daams, Joost G.
A1  - Thomsen, Katja
A1  - van Poelgeest, Eveline P.
A1  - Kamkar, Nellie
A1  - Seppala, Lotta J.
A1  - van der Velde, Nathalie
A1  - Petrovic, Mirko
SP  - afac191
EP  - afac191
VL  - 51
IS  - 9
N2  - BACKGROUND: our aim was to assess the effectiveness of medication review and deprescribing interventions as a single intervention in falls prevention. <br><br>DESIGN: systematic review and meta-analysis. DATA SOURCES: Medline, Embase, Cochrane CENTRAL, PsycINFO until 28 March 2022. ELIGIBILITY CRITERIA: randomised controlled trials of older participants comparing any medication review or deprescribing intervention with usual care and reporting falls as an outcome. STUDY RECORDS: title/abstract and full-text screening by two reviewers. RISK OF BIAS: Cochrane Collaboration revised tool. DATA SYNTHESIS: results reported separately for different settings and sufficiently comparable studies meta-analysed. <br><br>RESULTS: forty-nine heterogeneous studies were included. COMMUNITY: meta-analyses of medication reviews resulted in a risk ratio (RR) of 1.05 (95% confidence interval, 0.85-1.29, I2 = 0%, 3 studies(s)) for number of fallers, in an RR = 0.95 (0.70-1.27, I2 = 37%, 3 s) for number of injurious fallers and in a rate ratio (RaR) of 0.89 (0.69-1.14, I2 = 0%, 2 s) for injurious falls. HOSPITAL: meta-analyses assessing medication reviews resulted in an RR = 0.97 (0.74-1.28, I2 = 15%, 2 s) and in an RR = 0.50 (0.07-3.50, I2 = 72% %, 2 s) for number of fallers after and during admission, respectively. LONG-TERM CARE: meta-analyses investigating medication reviews or deprescribing plans resulted in an RR = 0.86 (0.72-1.02, I2 = 0%, 5 s) for number of fallers and in an RaR = 0.93 (0.64-1.35, I2 = 92%, 7 s) for number of falls. <br><br>CONCLUSIONS: the heterogeneity of the interventions precluded us to estimate the exact effect of medication review and deprescribing as a single intervention. For future studies, more comparability is warranted. These interventions should not be implemented as a stand-alone strategy in falls prevention but included in multimodal strategies due to the multifactorial nature of falls.PROSPERO registration number: CRD42020218231.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-0729
UR  - http://dx.doi.org/10.1093/ageing/afac191
ID  - ref1
ER  -