Table 1 Key question 1 eligibility criteria

Population

Community-dwelling adults aged 65 years or older.

Studies recruiting adults under the age of 65 may be included if one of the following applies:

- > 80% of the study sample are aged 65 years and older;

- Participants’ mean age minus one standard deviation is equal to or greater than 65;

- Results for adults 65 years and older are provided separately in stratified randomized studies.

Studies focussed only on participants < 65 years old.

Intervention

Single or multiple component interventions that are delivered by or initiated by first contact care providers (such as family physicians, general practitioners, pharmacists, nurses, geriatricians, physician assistants) to reduce potentially inappropriate prescription and/or over-the-counter medication use (e.g., medication review, electronic decision support system, patient/clinician education).

Interventions may be targeting one specific drug or drug class, or multiple drugs and drug classes (drug[s] must be assigned a Drug Identification Number (DIN) or international non-proprietary name (INN)).

Interventions focussed only on complementary alternative medications.

Comparator

No intervention, usual care, non- or minimally-active intervention.

Single or multiple component interventions to reduce potentially inappropriate prescription and/or over-the-counter medication use.

Outcomes

Critical/primary

1. All-cause mortality (benefit or harm)

2. Hospitalization (benefit or harm)

3. Non-serious (i.e., not requiring hospitalization and not causing death) adverse drug reactions including those related to withdrawal or stopping medication (benefit or harm)

Important/secondary

4. Quality of life (benefit or harm)

5. Emergency department visits (benefit or harm)

6. Injurious falls (benefit or harm)

7. Medical visits (benefit or harm)

8. Number of medications (and number of pills) (benefit)

Outcomes all-cause mortality, hospitalization, non-serious adverse drug reactions, quality of life, emergency department visits, injurious falls and medical visits may be considered as a benefit or harm of the intervention depending on the direction of effect.

Setting

Primary care;

Settings relevant to primary care where intervention is delivered by or initiated by first contact care providers (such as home, community, nursing/long-term care homes, pharmacy, emergency department).

Studies focussed on settings not relevant to primary care (e.g., acute care inpatient setting, specialist clinics).

Study design

Randomized controlled trials (RCTs) (individual or cluster)

Systematic reviews, non-randomized controlled trials, observational study designs (e.g., cohort studies), descriptive study designs (e.g., case reports, case series).

Letters, commentaries, editorials.

Publication language

English or French

Languages other than English and French

Dates of publication

No year limitation