User:MehaBhatt/sandbox

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Polypharmacy (Nov 23rd in-class Wiki session work)

 * This is a place to practice clicking the "edit" button and practice adding references (via the citation button).

Assignment # 3
Article Title: Polypharmacy

1.             Proposed Changes (2 marks):


 * The definition of polypharmacy is currently reported in the first sentence, “Polypharmacy is the concurrent use of multiple medications by a patient” and again in the second paragraph “The definition of polypharmacy is still debated. Definitions have ranged from...”. I propose to add the following updated definition: “Polypharmacy is most commonly defined as the use of five or more medications daily by an individual. However, the definition of polypharmacy is still debated and can vary from two to 11 concurrent medications. Some studies also generally define polypharmacy as the use of multiple concurrent medications or simultaneous long term use of different drugs by the same individual.”
 * Add the following updated reference for the definition of polypharmacy: Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC geriatrics. 2017 Dec 1;17(1):230.
 * Reorganize the first two paragraphs such that the definition alone appears in the first paragraph.

2.              Rationale for proposed change (3 marks):


 * The article currently reports multiple definitions of polypharmacy across two paragraphs, which appears disorganized. This can also make it difficult for the reader to develop an understanding of the term and follow the article. We propose to clarify the definition to include the numerical value that is most commonly reported, with a statement that it can vary across studies.
 * The definition is not clearly indicated in the first sentence. The addition of the definition at the start of the article will increase readability for the rest of the article and improve overall organization. We propose to move the definition to the start of the article and shift down the sentences following the definition into a second paragraph.
 * A comprehensive systematic review published in 2017 by Masnoon et. al synthesizes evidence from 110 studies on the definition of polypharmacy. I propose to add this reference for the definition and remove the current citation, which is a small primary study. The review reports that the most common definition of polypharmacy is five or more medications daily with a range of two to 11 medications, rather than two to 18 as reported in the current Wikipedia article. Therefore, I propose to add the descriptive and numerical definition from this high-quality review.

3.              Area of controversy (if applicable) (1 mark):

The numerical definition of polypharmacy can be ambiguous because it can vary between studies. The definition that I am adding is largely in line with what is already reported in the current Wikipedia article and I will also state that the definition continues to vary in the literature. As well, the updated reference is a comprehensive and recently published systematic review which provides stronger evidence for the definition than the currently cited references.

4.              Critique of source (2 marks):

The selected source is a systematic review that synthesizes the evidence on definitions of polypharmacy. Strengths of the review include a broad search of Medline, Embase, and Cochrane databases of studies published between 2000 and 2016. Limitations of the paper are that one primary author conducted title and abstract screening which can lead to selection bias. The review also included only English language studies which can also be a source of selection bias.

5.              Article improvement (2 marks): Proposed changes added to Wikipedia Talk Page.

What to post on the talk page?

 * This will also be covered on Nov 23rd in class. Your group should use the below template to share an outline of your proposed improvements (including your new wording and citations). Article talk pages are not places to share your assignment answers. The Wikipedia community will be more interested in viewing your exact article improvement suggestions including where you plan to improve the article (which section), what wording you suggest, and the exact citation (Note: all citations must meet WP:MEDRS)
 * You will not be able to paste citations directly from your sandbox to talk pages (unless you are interested in editing/learning Wiki-code in the "source editing" mode). We suggest re-adding your citations on the talk page manually (using the cite button and populating the citation by pasting in the DOI, website, or PMID). You will have to repeat this process yet again when you edit the actual article live.
 * Talk Page Template: CARL Medical Editing Initiative/Fall 2020/Talk Page Template