TY - JOUR T1 - Potentially Inappropriate Prescribing Among Older Persons: A Meta-Analysis of Observational Studies JF - The Annals of Family Medicine JO - Ann Fam Med SP - 257 LP - 266 DO - 10.1370/afm.2373 VL - 17 IS - 3 AU - Tau Ming Liew AU - Cia Sin Lee AU - Kuan Liang Goh Shawn AU - Zi Ying Chang Y1 - 2019/05/01 UR - http://www.annfammed.org/content/17/3/257.abstract N2 - PURPOSE Potentially inappropriate prescribing (PIP) is a common yet preventable medical error among older persons in primary care. It is uncertain whether PIP produces adverse outcomes in this population, however. We conducted a systematic review with meta-analysis to pool the adverse outcomes of PIP specific to primary care.METHOD We searched PubMed, Embase, CINAHL, Web of Science, Scopus, PsycINFO, and previous review articles for studies related to “older persons,” “primary care,” and “inappropriate prescribing.” Two reviewers selected eligible articles, extracted data, and evaluated the risk of bias. Meta-analysis was conducted to pool studies with similar PIP criteria and outcome measures.RESULTS Of the 2,804 articles identified, we included 8 articles with a total of 77,624 participants. All included studies had cohort design and low risk of bias. Although PIP did not affect mortality (risk ratio [RR] 0.98; 95% CI, 0.93-1.05), it was significantly associated with the other available outcomes, including emergency room visits (RR 1.63; 95% CI, 1.32-2.00), adverse drug events (RR 1.34; 95% CI, 1.09-1.66), functional decline (RR 1.53; 95% CI, 1.08-2.18), health-related quality of life (standardized mean difference –0.26; 95% CI, –0.36 to –0.16), and hospitalizations (RR 1.25; 95% CI, 1.09-1.44). A majority of the pooled estimates had negligible heterogeneity.CONCLUSIONS This meta-analysis provides consolidated evidence on the wide-ranging impact of PIP among older persons in primary care. It highlights the need to identify PIP in primary care, calls for further research on PIP interventions in primary care, and points to the need to consider potential implications when deciding on the operational criteria of PIP. ER -