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Reducing Medication-related Inappropriateness in Older Adults: A Systematic Review and Meta-analysis

Jeong-Ah Kim1, Daniel Terry2,3,4, Hoang Nguyen5

  • 1School of Nursing, Paramedicine and Healthcare Sciences, Charles Stuart University, NSW.

Journal of Patient Safety
|August 14, 2025
PubMed
Abstract

Insights

Interventions significantly reduce medication-related inappropriateness (MRI) in older adults by 57%. Educational programs and decision-support systems improve medication safety for elderly patients in aged care.

Area of Science:

  • Geriatric Medicine
  • Pharmacology
  • Health Services Research

Background:

  • Medication-related inappropriateness (MRI) is a significant risk for elderly patients, especially in aged care.
  • Addressing MRI is crucial for enhancing patient safety and health outcomes in older adults.

Purpose of the Study:

  • To evaluate the effectiveness of interventions designed to reduce MRI in elderly populations.
  • To improve prescribing practices in aged care settings through systematic review and meta-analysis.

Main Methods:

  • Systematic review and meta-analysis of RCTs and non-RCTs (April 2020-November 2023).
  • Searched databases: MEDLINE, EMBASE, CINAHL, PubMed, EBSCOhost.
  • Included 8 studies with 33,170 participants; analyzed pooled odds ratio (OR) using a random-effects model.

Main Results:

  • Interventions included educational programs, peer reviews, and computerized decision-support systems.
  • Significant reduction in MRI observed, with a pooled OR of 0.43 (57% reduction).
  • Educational interventions showed particular effectiveness in improving prescriber behavior and medication safety.

Conclusions:

  • Educational interventions and decision-support systems effectively reduce inappropriate medication prescribing in older patients.
  • Further research is needed to address heterogeneity, long-term outcomes, and implementation strategies for improved medication safety.
Keywords:
elderly patientsmedication errormedication-related inappropriatenesspatient safetypotentially inappropriate medicationpotentially inappropriate medication administrationpotentially inappropriate prescription

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