BMJ Open (Nov 2021)
Protocol for a systematic review and meta-analysis assessing the effectiveness of deprescribing in falls prevention in older people
- Olive Kobusingye,
- Kenneth Madden,
- Jesper Ryg,
- Gustavo Duque,
- Leilei Duan,
- Ian Cameron,
- Clemens Becker,
- Chris Todd,
- Pip Logan,
- Nathalie van der Velde,
- Sirpa Hartikainen,
- Alice Nieuwboer,
- Luigi Ferrucci,
- Jacqueline Close,
- Stephen Lord,
- Cathie Sherrington,
- Ngaire Kerse,
- Jennifer Watt,
- Tischa van der Cammen,
- Matteo Cesari,
- Rose Anne Kenny,
- Luis Miguel Gutierrez-Robledo,
- Sallie Lamb,
- James Frith,
- Ellen Freiberger,
- Maw Pin Tan,
- Sebastiana Kalula,
- Koen Milisen,
- Tahir Masud,
- Joe Verghese,
- Mirko Petrovic,
- Dawn Skelton,
- Joost Daams,
- MEG MORRIS,
- Lotta J Seppala,
- Nellie Kamkar,
- Manuel M Montero-Odasso,
- Ellen Vlaeyen,
- Robert Bourke,
- Finbarr C. Martin,
- David R. Marsh,
- Hubert Blain,
- Cedric Anweiller,
- Alvaro Casas-Herrero,
- Javier Perez Jara,
- Christina Alonzo Bouzòn,
- Ana-Karim Welmer,
- Stephanie Birnghebuam,
- Reto Kressig,
- Manuel Montero-Odasso,
- Mark Speechley,
- Bill McIlroy,
- Susan Hunter,
- Richard Camicioli,
- Mireille Norris,
- Louise Mallet,
- David B. Hogan,
- Ervin Sejdic,
- Lewis Lipsitz,
- David A. Ganz,
- Neil B. Alexander,
- Fabiana Giber,
- Marcelo Schapira,
- Ricardo Jauregui,
- Felipe Melgar-Cuellar,
- Roberto Alves Lourenço,
- Monica Pierrucini,
- Alejandro Ceriani,
- Pedro Marín-Larraín,
- Homero Gac Espinola,
- José Fernando Gómez-Montes,
- Carlos Alberto Cano-Gutierrez,
- Xinia Ramirez Ulate,
- José Ernesto Picado Ovares,
- Patricio Gabriel Buendia,
- Susana Lucia Tito,
- Diego Martínez Padilla,
- Sara G. Aguilar-Navarro,
- Alberto Mimenza,
- Rogelio Moctezum,
- Alberto Avila-Funes,
- Luis Manuel Cornejo Alemán,
- Edgar Aguilera Caona,
- Juan Carlos Carbajal,
- José F. Parodi,
- Aldo Sgaravatti,
- Cathy Said,
- Ryota Sakurai,
- Chek Hooi Wong,
- Chang Won Won,
- Jeffrey Hausdorff
Affiliations
- Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
- Kenneth Madden
- Jesper Ryg
- 3 Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Gustavo Duque
- Leilei Duan
- Division of Injury Prevention, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Ian Cameron
- Rehabilitation and Aged Care Services, Northern Sydney Local Health District, Sydney, New South Wales, Australia
- Clemens Becker
- Unit of Digital Geriatric Medicine, Heidelberg University Hospital, Heidelberg, Germany
- Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Pip Logan
- Community Health Sciences, University of Nottingham, Nottingham, UK
- Nathalie van der Velde
- Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
- Sirpa Hartikainen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
- Alice Nieuwboer
- Luigi Ferrucci
- Jacqueline Close
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- Stephen Lord
- Cathie Sherrington
- Ngaire Kerse
- Harkness fellow
- Jennifer Watt
- University of Toronto, Toronto, Ontario, Canada
- Tischa van der Cammen
- Matteo Cesari
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
- Rose Anne Kenny
- Luis Miguel Gutierrez-Robledo
- Sallie Lamb
- College of Medicine and Health, University of Exeter, Exeter, UK
- James Frith
- Ellen Freiberger
- Maw Pin Tan
- Sebastiana Kalula
- Koen Milisen
- Tahir Masud
- consultant geriatrician
- Joe Verghese
- Mirko Petrovic
- Department of Internal Medicine and Paediatrics (Section of Geriatrics), Ghent University, Ghent, Belgium
- Dawn Skelton
- Joost Daams
- 4 Medical Library, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
- MEG MORRIS
- Lotta J Seppala
- Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
- Nellie Kamkar
- Gait and Brain Laboratory, Lawson Research Health Institute, Parkwood Hospital, London, Ontario, Canada
- Manuel M Montero-Odasso
- Gait and Brain Lab, Lawson Research Health Institute, Parkwood Hospital, London, Ontario, Canada
- Ellen Vlaeyen
- Robert Bourke
- 7Monash Health, Melbourne, VIC, Australia
- Finbarr C. Martin
- David R. Marsh
- Hubert Blain
- Cedric Anweiller
- Alvaro Casas-Herrero
- Javier Perez Jara
- Christina Alonzo Bouzòn
- Ana-Karim Welmer
- Stephanie Birnghebuam
- Reto Kressig
- Manuel Montero-Odasso
- Mark Speechley
- Departments of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Bill McIlroy
- Susan Hunter
- Richard Camicioli
- Mireille Norris
- Louise Mallet
- David B. Hogan
- Ervin Sejdic
- Lewis Lipsitz
- Harvard Medical School, Boston, Massachusetts, USA
- David A. Ganz
- Neil B. Alexander
- Fabiana Giber
- Marcelo Schapira
- Ricardo Jauregui
- Felipe Melgar-Cuellar
- Roberto Alves Lourenço
- Monica Pierrucini
- Alejandro Ceriani
- Pedro Marín-Larraín
- Homero Gac Espinola
- José Fernando Gómez-Montes
- Carlos Alberto Cano-Gutierrez
- Xinia Ramirez Ulate
- José Ernesto Picado Ovares
- Patricio Gabriel Buendia
- Susana Lucia Tito
- Diego Martínez Padilla
- Sara G. Aguilar-Navarro
- Alberto Mimenza
- Rogelio Moctezum
- Alberto Avila-Funes
- Luis Manuel Cornejo Alemán
- Edgar Aguilera Caona
- Juan Carlos Carbajal
- José F. Parodi
- Aldo Sgaravatti
- Cathy Said
- Ryota Sakurai
- Chek Hooi Wong
- Chang Won Won
- Jeffrey Hausdorff
- DOI
- https://doi.org/10.1136/bmjopen-2020-047190
- Journal volume & issue
-
Vol. 11,
no. 11
Abstract
Introduction One of the known risk factors for fall incidents is the use of specific medications, fall-risk-increasing drugs (FRIDs). However, to date, there is uncertainty related to the effectiveness of deprescribing as a single intervention in falls prevention. Thus, a comprehensive update of the literature focusing on all settings in which older people receive healthcare and all deprescribing interventions is warranted to enhance the current knowledge.Methods and analysis This systematic review protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search was performed in Cochrane Central Register of Controlled Trials, MEDLINE, Embase and PsycINFO (2 November 2020). We will also search in trial registers. We will include randomised controlled trials, in which any deprescribing intervention is compared with usual care and reports falls as an outcome. Both title and abstract screening and full-text screening will be done by two reviewers. The Cochrane Collaboration revised tool of Risk of Bias will be applied to perform risk of bias assessment. We will categorise the results separately for every setting. If a group of sufficiently comparable studies will be identified, we will perform a meta-analysis applying random effects model. We will investigate heterogeneity using a combination of visual inspection of the forest plot along with consideration of the χ2 test and the I2 statistic results. We have prespecified several subgroup and sensitivity analyses.Ethics and dissemination Ethics approval is not applicable for this study since no original data will be collected. The results will be disseminated through peer-reviewed publication and conference presentations. Furthermore, this systematic review will inform the recommendations of working group of polypharmacy and FRIDs of the anticipated World’s Falls Guidelines.PROSPERO registration number CRD42020218231.
