Spinal cord injury and polypharmacy: a scoping review
Bibliographic record
Abstract
Purpose: The purpose of this scoping review was to map the scope of the literature on polypharmacy among individuals with spinal cord injury or dysfunction (SCI/D). Material and methods: Five electronic databases were searched for literature published between January 1990 and July 2018. The following keywords were searched using Boolean operators, wild cards, proximity operators and truncations: spinal cord injuries, multiple medications, polypharmacy. The initial search identified 1,459 articles; 1,098 remained after deduplication. Following the title and abstract screen, 81 full-texts were reviewed, and 18 met all of the eligibility criteria for inclusion in the review. Results: Of the 18 studies identified, less than half defined polypharmacy. Definitions varied in the types and number of medications. Older age, higher level of injury and greater severity of injury were factors related to polypharmacy. Negative clinical outcomes, such as drug-related problems and bowel complications were identified. Conclusions: This scoping review identified a paucity of research on polypharmacy post-SCI/D, highlighting a need for future research. To improve the state of knowledge, there is a need to better understand factors and clinical outcomes related to polypharmacy in persons with SCI/D and to explore experiences of persons with SCI/D, caregivers and clinicians relating to polypharmacy.Implications for rehabilitationPrescribers should be aware of the factors and negative clinical outcomes related to polypharmacy and spinal cord injuries/dysfunction, especially for patients with higher level and more severe injuries.Prescribers should work with their patients with spinal cord injuries/dysfunction to avoid inappropriate polypharmacy and to integrate appropriate alternatives to medications.Optimizing medication management should be a significant focus of spinal cord injury/dysfunction rehabilitation and research in order to develop targeted interventions that improve patient outcomes. Prescribers should be aware of the factors and negative clinical outcomes related to polypharmacy and spinal cord injuries/dysfunction, especially for patients with higher level and more severe injuries. Prescribers should work with their patients with spinal cord injuries/dysfunction to avoid inappropriate polypharmacy and to integrate appropriate alternatives to medications. Optimizing medication management should be a significant focus of spinal cord injury/dysfunction rehabilitation and research in order to develop targeted interventions that improve patient outcomes.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.055 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.018 | 0.021 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".