@article{ref1,
title="Health outcomes associated with polypharmacy in community-dwelling older adults: a systematic review",
journal="Journal of the American Geriatrics Society",
year="2014",
author="Fried, Terri R. and O'Leary, John and Towle, Virginia and Goldstein, Mary K. and Trentalange, Mark and Martin, Deanna K.",
volume="62",
number="12",
pages="2261-2272",
abstract="OBJECTIVES: To summarize evidence regarding the health outcomes associated with polypharmacy, defined as number of prescribed medications, in older community-dwelling persons. <br><br>DESIGN: Systematic review of MEDLINE (OvidSP 1946 to May, Week 3, 2014). SETTING: Community. PARTICIPANTS: Observational studies examining health outcomes according to number of prescription medications taken. MEASUREMENTS: Association between number of medications and health outcomes. Because of the importance of comorbidity as a potential confounder of the relationship between polypharmacy and health outcomes, articles were assessed regarding the quality of their adjustment for confounding. <br><br>RESULTS: Of the 50 studies identified, the majority that were rated good in terms of their adjustment for comorbidity demonstrated relationships between polypharmacy and a range of outcomes, including falls, fall outcomes, fall risk factors, adverse drug events, hospitalization, mortality, and measures of function and cognition. However, a number of these studies failed to demonstrate associations, as did a substantial proportion of studies rated fair or poor. <br><br>CONCLUSION: Data are mixed regarding the relationship between polypharmacy, considered in terms of number of medications, and adverse outcomes in community-dwelling older persons. Because of the challenge of confounding, randomized controlled trials of medication discontinuation may provide more-definitive evidence regarding this relationship than observational studies can provide.<p /> <p>Language: en</p>",
language="en",
issn="0002-8614",
doi="10.1111/jgs.13153",
url="http://dx.doi.org/10.1111/jgs.13153"
}