Beneficial outcomes of medication review in patients with hip fractures: a systematic review

Abstract

Purpose: This study aims to analyze medication review efficacy toward clinical outcomes in older adults with hip fractures.

Methods: A systematic search was conducted using the modified keywords "medication review," "polypharmacy," and "hip fractures" to find relevant studies. Following the PRISMA guidelines, we reviewed published studies from 2014 to 2024. A total of 21 studies have been identified, six of which reported medication reviews for older adults with hip fractures.

Results: The findings highlight the critical need for a multi-faceted strategy to address the challenges of polypharmacy in older adults with hip fractures. A higher number of medications is associated with some adverse outcomes, such as increased hospitalization rates, longer recovery times, and a greater incidence of pressure ulcers. Although minimizing inappropriate medications may show some positive results, focusing solely on medication management is insufficient in this vulnerable population.

Conclusion: Medication reviews have substantially mitigated medication-related issues, including costs, drug efficacy, and patient discomfort. Nevertheless, clinical outcomes have yet to exhibit significant improvement, which presents an opportunity for further research to explore the potential benefits of medication reviews in enhancing the care of patients with hip fractures. A holistic approach, which consists of medication review, patient education, and tailored rehabilitation programs, may be essential to improve recovery, decrease hospitalization rates, and prevent adverse events.

Keywords: Hip fractures; Medication review; Older adults; Polypharmacy.

Fig. 1

ROBINS-2 (Risk of Bias Interventional Study) assessment of included studies

Fig. 2

PRISMA flow-chart of study recruitment

Fig. 3

Venn-diagram adaptation of medication review approach to create an impactful intervention