Table 3.
Summary of findings.
| Outcomes | Median (range) | Number of participants (studies) | Certainty of the evidence (GRADE) | Comments |
|---|---|---|---|---|
|
The proportion of patients with one or more potentially inappropriate medications (PIMs) and/or potential prescribing omissions (PPOs) Assessed with: explicit validated tools |
34.6% (6.5–95.8)a | 1,139,693 (26) |
⊕ ⊝ ⊝ ⊝ VERY LOWb |
Austrian consensus panel list78, 1997 Beers criteria10, 2003 Beers criteria11, American Geriatrics Society (AGS) 2012 Beers criteria12, AGS 2015 Beers criteria13, Comprehensive protocol79, 2012 CZ expert consensus criteria80, EU(7)-PIM list81, French consensus panel list82, Ghent Older People's Prescriptions community Pharmacy Screening (GheOP3S) tool83, McLeod criteria84, PRISCUS list85, Screening Tool to Alert doctors to Right Treatment (START)15, START criteria version 216, Screening Tool of Older Person's Prescriptions (STOPP)15, STOPP criteria version 216 and composite tools (combinations of two or more tools) |
GRADE Working Group grades of evidence: High quality – we are very confident that the true effect lies close to that of the estimate of the effect; Moderate quality – we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different; Low quality – our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect; Very low quality – we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.
aOne study by Kosinska et al.61 and part of the results from one study by Popovic et al.68 were excluded from the analysis because a unit of analysis was prescription, not a patient.
bWe downgraded the evidence three levels from high to very low due to the risk of bias (most studies at high or unclear risk of bias), imprecision (number of studies with small sample sizes), and inconsistency (considerable heterogeneity).