META ANALYSIS

Meta Analysis and Systematic Review

Abstract

Concern with the impact of prescriptions in aging populations has led to several strategies to deal with this situation, such as detecting potentially inappropriate medications (PIMs). Drugs are potentially inappropriate in elderly patients when there is no evidence-based indication for their use, when they increase the risk of adverse effects compared to younger patients, or when they are not cost-effective. These drugs may also be associated with increased morbidity, mortality, and the cost of health services. Avoiding high-risk medication is an important strategy for reducing adverse events to drugs - particularly the adverse reactions.

Table of Content

Abstractii

Background1

Meta Analysis and Systematic Review2

Tamblyn et al 20032

Raebel et al 20073

Terrel et al 20094

Conclusion7

References9

Meta Analysis and Systematic Review on Inappropriate Medicines Prescribing To Elderly

Background

The overall objective of this systematic review is to determine the best available evidence related to the effectiveness of computer systems tools that assist in clinical decision making regarding reduction in frequency of potentially inappropriate medications (PIMs) ordered at discharge and PIMs-related unplanned emergency room (ER) visits or hospital readmissions in community dwelling patients > 65 years of age.

More specifically, the focused systematic review question is: what is the effectiveness of computer systems tools that assist in clinical decision making on reduction in frequency of PIMs ordered at discharge and PIMs-related unplanned ER visits or hospital readmissions in community dwelling patients > 65 years of age?

Many researchers have studied the phenomenon of potentially inappropriate prescription given to elderly people. This issue is quite regular in ambulatory environments, emergencies and nursing homes.

A meta-analysis of 3 studies (Raebel el al 2007, Tamblyn el al 2003 andTerrel el al 2009) revealed the exposure of elderly to possible new and unwanted prescriptions, several suppliers and physicians and protective hospital pharmacopeias which involves reconciliation with the medications taken at home. All these features can potentially increase the threat of potentially inappropriate medications. To deal with this public health dilemma in elderly patients, especially inside the hospital surroundings, it is necessary that practitioners know the possible risks involved with potentially inappropriate medications, the benefits and restriction of authenticated drug evaluation techniques for identifying potentially inappropriate medications and feasible premeditated techniques to curtail the problem.

Meta Analysis and Systematic Review

Tamblyn et al 2003

Tamblynet et al (2003) set out to establish that whether potentially inappropriate medications can be cut down by computer systems decision making tools. The study revealed that digital access to entire medication profiles and warnings reduced the initiation rate of inappropriate medications by 18% (RR=0.82, 95% CI=0.69-0.98).

This research study also demonstrated the scale of the challenge which is associated with organizing healthcare for old aged patients in an urbanized environment. Preliminary care practitioners provide only one-half of the total medical assistance to the old aged patients. These patients also receive medications from three other practitioners, at least, and receive their medications from various pharmacies. Tamblynet et al (2003) addressed the issue of insufficient information on present medication use by means of existing information regarding the claims of medication in order to achieve a ...