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
While a great amount of practical attention has been paid to the location of medical specialists' office, little research has been published in Korean medical journals. This study examines the concentration level and the related factors of the location of medical specialists' offi ce. For the related factors of the location, this study considers 1) the relative infl uence of resident vs. daytime population, 2) the relative infl uence of resident vs. university-graduate population, and 3) the ratio of aged population. Methods: This study utilized the Korea Medical Association's "2006 Annual Report Membership Statistics" and the Korea National Statistical Offi ce's "2005 National Population and Housing Census" as data sources. Results: The location of plastic surgeons, dermatologists, psychiatrists, ophthalmologists, and urologists' offi ce was more concentrated than the average, while the reverse was true for obstetricians, gynecologists, orthopedic surgeons, internists, family physicians, and general surgeon's offi ce. Daytime population was more correlated with the location of doctors' office than resident population in most specialties, with the exception of pediatrics, orthopedic surgery and internal medicine. While university-graduates population was more associated with the location than resident population in most specialties, the reverse was true for orthopedic surgery, obstetrics & gynecology, and pediatrics. The ratio of aged population was negatively associated with the location in all the specialties. Conclusion: The concentration level showed considerable differences across specialties. Daytime population and university-graduate population were more related with the location of doctors' offi ce than resident population in most specialties.

Citations

• Equitable City in an Aging Society: Public Transportation-Based Primary Care Accessibility in Seoul, Korea
  Yoonchae Yoon, Jina Park
  Sustainability.2022; 14(16): 9902.     CrossRef