Table 3 Medication management interventions for older adults in ED, by intervention category and level of evidence

Medication management to improve system performance

Liu et al., 2019, Taiwan [91]

Reduction in major polypharmacy (≥ 10 medications) at hospital discharge compared with on admission to the ED, %

-65.3

-79.4

 < 0.001*

III-2

 + 

Reduction in PIMs at hospital discharge compared with on admission to the ED, %

-49.1

-67.5

 < 0.001*

 + 

Number of medications, mean (SD)

12.5 (2.7)

6.9 (3)

 < 0.001*

 + 

Matz et al., 2021, Germany [92]

Immediate drug interventions/recommendations for pre-existing medications, mean (SD)

1.24 (1.71)

3.28 (2.22)

 < 0.001*

III-2

 + 

Medications discontinued, mean (SD)

0.60 (1.25)

1.74 (1.32)

 < 0.001*

 + 

Medications commenced, mean (SD)

0.50 (0.93)

0.86 (0.93)

0.004*

 + 

Altered dose, mean (SD)

0.14 (0.35)

0.88 (0.82)

0.001*

 + 

FORTA drugs, n (%)

8/65 (12.3)

35/65 (53.9)

 < 0.001*

 + 

Stevens et al., 2017, USA [89]

PIMs prescribed—Site 1, % (SD)

11.9 (1.8)

5.1 (1.4)

 < 0.001*

III-2

 + 

PIMs prescribed—Site 2, % (SD)

8.2 (0.8)

4.5 (1.0)

 < 0.001*

 + 

PIMs prescribed—Site 3, % (SD)

8.9 (1.9)

6.1 (1.7)

 < 0.001*

 + 

PIMs prescribed—Site 4, % (SD)

7.4 (1.7)

5.7 (0.8)

0.04*

 + 

Vaughan et al., 2021, USA [90]

PIMs prescribed—Site 1, % (95% CI)

5.6 (5.0, 6.3)

5.1 (4.7, 5.5)

0.02*

III-2

 + 

PIMs prescribed—Site 2, % (95% CI)

5.8 (5.0, 6.6)

5.4 (4.8, 6.0)

0.62

ne

PIMs prescribed—Site 3, % (95% CI)

7.3 (6.4, 9.2)

7.5 (6.6, 8.4)

0.64

ne

Medication management to improve staff experience

Moss et al., 2019, USA [93]

Self-reported confidence in prescribing for older adults, %

80

100

0.005*

III-2

 + 

PIMs prescribed to older adults by physician residents, rate ratio (95% CI)

0.73 (0.63, 0.85

 < 0.001*

 +