Table 1.
Map of evidence on interventions for clinical outcomes.
| Interventions | Clinical outcomes | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Polypharmacy: medication errors | Adherence | Drug-related problems | |||||||
| Reduction of potentially inappropriate prescriptions (PIP) | Improvement of use of appropriate and safe medications | Improvement of adherence | Reduction of adverse drug events | Reduction of adverse drug reactions | Reduction of drug-drug interactions | Reduction of drug-related negative health Outcomes | |||
| Professional interventions | Targeted at prescribers | Clinical case analysis and/or evaluation | (Kaur et al., 2009; Alldred et al., 2013; Olaniyan et al., 2015) | (Kaur et al., 2009; Alldred et al., 2013; Olaniyan et al., 2015) | (Kaur et al., 2009; Alldred et al., 2013; Olaniyan et al., 2015) | * | * | * | * |
| Review of drug use | (Hajjar et al., 2007; Kaur et al., 2009; Mathumalar et al., 2011; Patterson et al., 2012; Cooper et al., 2015; Jórdan-Sánchez et al., 2015; Olaniyan et al., 2015; Khalil et al., 2017) | (Hajjar et al., 2007; Kaur et al., 2009; Mathumalar et al., 2011; Patterson et al., 2012; Cooper et al., 2015; Jórdan-Sánchez et al., 2015; Olaniyan et al., 2015; Khalil et al., 2017) | (Hajjar et al., 2007; Kaur et al., 2009; Mathumalar et al., 2011; Patterson et al., 2012; Cooper et al., 2015; Jórdan-Sánchez et al., 2015; Olaniyan et al., 2015; Khalil et al., 2017) | (Hajjar et al., 2007) | (Hajjar et al., 2007) | (Hajjar et al., 2007) | (Hajjar et al., 2007) | ||
| Educational interventions for prescribers | (Hajjar et al., 2007; Kaur et al., 2009; Mathumalar et al., 2011; Olaniyan et al., 2015) | (Hajjar et al., 2007; Kaur et al., 2009; Mathumalar et al., 2011; Olaniyan et al., 2015) | (Hajjar et al., 2007; Kaur et al., 2009; Mathumalar et al., 2011; Olaniyan et al., 2015) | * | * | * | * | ||
| Targeted at users and caregivers | Educational interventions for users and/or caregivers | (Kaur et al., 2009; Mathumalar et al., 2011; Olaniyan et al., 2015) | (Kaur et al., 2009; Mathumalar et al., 2011; Olaniyan et al., 2015) | (Kaur et al., 2009; Mathumalar et al., 2011; Olaniyan et al., 2015) | * | * | * | * | |
| Organizational interventions | Use of information and communication technology | Active search for user data and information | (Olaniyan et al., 2015) | (Olaniyan et al., 2015) | (Olaniyan et al., 2015) | * | * | * | * |
| Drug information services | (Kaur et al., 2009) | (Kaur et al., 2009) | (Kaur et al., 2009) | * | * | * | * | ||
| Clinical decision-making support systems | (Kaur et al., 2009; Mathumalar et al., 2011; Cooper et al., 2015) | (Kaur et al., 2009; Mathumalar et al., 2011; Cooper et al., 2015) | (Kaur et al., 2009; Mathumalar et al., 2011; Cooper et al., 2015) | * | * | * | * | ||
| Use of risk screening tools | (Patterson et al., 2012; Olaniyan et al., 2015) | (Patterson et al., 2012; Olaniyan et al., 2015) | (Patterson et al., 2012; Olaniyan et al., 2015) | * | * | * | * | ||
| Provision of pharmaceutical care services | (Mathumalar et al., 2011; Patterson et al., 2012; Lee et al., 2013; Sáez-Benito et al., 2013; Cooper et al., 2015; Olaniyan et al., 2015; Babar et al., 2017) | (Mathumalar et al., 2011; Patterson et al., 2012; Lee et al., 2013; Sáez-Benito et al., 2013; Cooper et al., 2015; Olaniyan et al., 2015; Babar et al., 2017) | (Mathumalar et al., 2011; Patterson et al., 2012; Lee et al., 2013; Sáez-Benito et al., 2013; Cooper et al., 2015; Olaniyan et al., 2015; Babar et al., 2017) | (Lee et al., 2013) | (Lee et al., 2013) | (Lee et al., 2013) | (Lee et al., 2013) | ||
| Technical management of medications | (Olaniyan et al., 2015) | (Olaniyan et al., 2015) | (Olaniyan et al., 2015) | * | * | * | * | ||
| Financial interventions: incentive programs to change prescribing practices | * | * | * | * | * | * | * | ||
| Governmental Interventions | Regulatory interventions: governmental policies regulating prescriptions | (Kaur et al., 2009) | (Kaur et al., 2009) | (Kaur et al., 2009) | * | * | * | * | |
| Multifaceted interventions | (Hajjar et al., 2007; Alldred et al., 2013; Lee et al., 2013; Cooper et al., 2015; Olaniyan et al., 2015) | (Hajjar et al., 2007; Alldred et al., 2013; Lee et al., 2013; Cooper et al., 2015; Olaniyan et al., 2015) | (Hajjar et al., 2007; Alldred et al., 2013; Lee et al., 2013; Cooper et al., 2015; Olaniyan et al., 2015) | Sáez-Benito et al., 2013 | Sáez-Benito et al., 2013 | Sáez-Benito et al., 2013 | Sáez-Benito et al., 2013 | ||
The references in parentheses indicate the studies that presented evidence for each intervention/outcome studied.
*
Not studied and/or no evidence.
community-level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: overview of systematic reviews and economic evaluations.