Potentially inappropriate prescribing (PIP) is a major public health concern with several undesirable health consequences for older adults. In this overview, we aimed to map and gather information from existing literature to provide a better insight into the prevalence of PIP among community dwellers. Electronic databases were searched from their inception to April 2022. The quality of the included systematic reviews (SRs) was assessed using the assessment of multiple systematic reviews checklist. The degree of overlap within the SRs was also evaluated (2% overlap). All SRs on the prevalence of PIP in older individuals in community settings were included, and a narrative approach was used to synthesize data. Nineteen SRs comprising 548 primary studies met the inclusion criteria, and the average quality of the included SRs was moderate. More than half (50.5%) of the primary studies were conducted in Europe, followed by the United States (22.8%), and Asia (18.9%). Thirty different criteria were used in the primary studies to estimate the prevalence of PIP. The most widely used criteria were those presented in Beers (41.8%) and STOPP (Screening Tool of Older Persons’ Prescriptions)/START (Screening Tool to Alert to Right Treatment) (21.8%) criteria. Benzodiazepines, nonsteroidal anti-inflammatory drugs, and antidepressants were the most frequently reported PIPs. A considerable variation in the prevalence of PIP ranging from 0% to 98% was reported by SRs. However, there is a high degree of uncertainty regarding the extent of PIP in community settings. To identify knowledge-to-action gaps, SR authors should consider the differences in prevalence of PIP according to settings, applied tools, data sources, geographical areas, and specific pathologies. There is also a need for primary and SR studies from low- and middle-income countries regarding the prevalence of PIP.

Background
Breast cancer is the most commonly diagnosed tumorous cancer and the second leading cause of cancer-related deaths among women worldwide. This study aimed to qualitatively explore the barriers to mammography adoption among Iranian women.
Methods
This study is a qualitative component of a large research project on exploratory sequential mixed method design, utilizing conventional content analysis. In total, 24 participants were selected from among women who had participated in the first phase of the study. Data were collected through in-depth, semi-structured interviews.
Results
Five main themes were extracted, consisting of unawareness of mammography, fear control, priority of mammography needs, inadequate competency of mammography centers, and a sense of losing family support.
Conclusion
Different perceived barriers within various levels (individual, intrapersonal, health systems, and community) play influential roles in women’s decisions to participate in breast cancer screening program, which indicates the cultural aspect of perceived barriers in different communities and countries. The study provides the basis for intervention planning in this regard.

Citations

• Behind the Screen: An Exploratory Study of Factors Influencing Breast Screening Uptake in Lancashire (UK)
  Yik Nok Bryan Lee, Alexander Montasem, Lauren Haworth, Jonathan Sinclair, Kim McGuire, Ambreen Chohan
  Health Expectations.2025;[Epub]     CrossRef
• Anxiety Levels Among Women Undergoing Mammogram Screening
  Wedad M. Almutairi, Salwa Hassan Alzahrani
  Current Oncology.2025; 32(3): 160.     CrossRef
• Development and validation of the psychometric properties of the perceived barriers of mammography scale
  Shayesteh Shirzadi, Mohammad Asghari-Jafarabadi, Mahnaz M. Harrison, Hamid Allahverdipour
  Health Care for Women International.2024; 45(6): 621.     CrossRef
• Overcoming obstacles to mammography screening: Examining the role of offline healthcare barriers and online patient–provider communication
  Yuyuan Kylie Lai, Jizhou Francis Ye, Song Harris Ao, Xinshu Zhao
  Journal of Health Psychology.2024; 29(5): 452.     CrossRef
• Exploring the practice of Iranian adolescent females during menstruation and related beliefs: a qualitative study
  Mojgan Mirghafourvand, Abbas Ebadi, Shayesteh Jahanfar, Fatemeh Khorashadizadeh, Shayesteh Shirzadi
  BMC Public Health.2024;[Epub]     CrossRef
• Risk perception regarding social determinants of health among women with breast cancer in Iran: a qualitative study
  Arezou Ashari, Neda SoleimanvandiAzar, Marzieh Nojomi, Hadi Ranjbar, Kamran Mirzaei, Nahid Nafissi, Mahshid Roohravan Benis, Zahra Rampisheh
  BMJ Open.2024; 14(8): e081839.     CrossRef
• Need assessment for the content of educational programs about breast cancer from the viewpoint of unaffected women
  Sadaf Alipour, Marzieh Orouji, Yas Eskandari, Amirhossein Eskandari
  BMC Women's Health.2023;[Epub]     CrossRef
• Acceptability and compliance with a breast cancer prevention campaign in the Northwest Region, Iran
  Saeed Dastgiri, Geertruida H de Bock, Zohreh Sanaat, Mahnaz Ranjkesh, Zhila Abbasi, Pooneh Jabbaripour, Shima Pashaie, Soheila Poorsaberi, Roya Dolatkhah
  Breast Cancer Management.2022;[Epub]     CrossRef
• Qualitative factors influencing breast and cervical cancer screening in women: A scoping review
  Jerrald Lau, Pami Shrestha, Janelle Shaina Ng, Gretel Jianlin Wong, Helena Legido-Quigley, Ker-Kan Tan
  Preventive Medicine Reports.2022; 27: 101816.     CrossRef
• Factors Associated with Screening Mammogram Uptake among Women Attending an Urban University Primary Care Clinic in Malaysia
  Nasturah Abdullah, Noorhida Baharudin, Mariam Mohamad, Mohamed-Syarif Mohamed-Yassin
  International Journal of Environmental Research and Public Health.2022; 19(10): 6103.     CrossRef
• Breast Cancer in Asia: Incidence, Mortality, Early Detection, Mammography Programs, and Risk-Based Screening Initiatives
  Yu Xian Lim, Zi Lin Lim, Peh Joo Ho, Jingmei Li
  Cancers.2022; 14(17): 4218.     CrossRef
• Barriers to women’s breast cancer screening behaviors in several countries: A meta-synthesis study
  İlknur Özkan, Seçil Taylan
  Health Care for Women International.2021; 42(7-9): 1013.     CrossRef
• Beliefs, fear and awareness of women about breast cancer: Effects on mammography screening practices
  Lida Emami, Akram Ghahramanian, Azad Rahmani, Ahmad Mirza Aghazadeh, Tonia C. Onyeka, Amirreza Nabighadim
  Nursing Open.2021; 8(2): 890.     CrossRef
• A systematic review of decision aids for mammography screening: Focus on outcomes and characteristics
  Marzieh Esmaeili, Seyed Mohammad Ayyoubzadeh, Zohreh Javanmard, Sharareh R. Niakan Kalhori
  International Journal of Medical Informatics.2021; 149: 104406.     CrossRef
• Breast cancer screening behavior and its associated factors in female employees in South Khorasan
  Zoya Tahergorabi, Mahyar Mohammadifard, Fatemeh Salmani, Mitra Moodi
  Journal of Education and Health Promotion.2021; 10(1): 102.     CrossRef
• Fear of negative appearance evaluation and attitude towards mammography: Moderating role of internal health locus of control,cancer worry and age
  Saeed Pahlevan Sharif, Ashraf Sadat Ahadzadeh, Fon Sim Ong, Navaz Naghavi
  Health Promotion Perspectives.2020; 10(3): 220.     CrossRef
• Factors affecting mammography screening behaviour among rural Vietnamese women
  Linh Thuy Duong, Hui‐Mei Chen, Chieh‐Yu Liu, Piao‐Yi Chiou
  European Journal of Cancer Care.2020;[Epub]     CrossRef

• Perceived Barriers and Awareness of Mammography Screening Among Saudi Women Attending Primary Health Centers

  
  Doaa M Abdel-Salam, Rehab A Mohamed, Hind Y Alyousef, Wahaj A Almasoud, Mashael B Alanzi, Atheer Z Mubarak, Doaa M Osman
  Risk Management and Healthcare Policy.2020; Volume 13: 2553.     CrossRef