Pharmacological and Adjunctive Wound Healing Interventions in the Elderly: A Systematic Review and Meta-Analysis with Implications for Pharmacy Practice
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Keywords
wound healing, elderly, biological dressings, meta-analysis
Abstract
Background: Chronic wound healing in elderly populations is complicated by age-related physiological decline, multimorbidity, polypharmacy, and underrepresentation in clinical trials. Pharmacists play an expanding role in multidisciplinary geriatric wound care, particularly in optimizing topical therapies, nutritional support, and deprescribing. Objective: To evaluate the effectiveness of wound healing interventions in elderly individuals (aged ≥60 years), focusing on pharmacist-relevant strategies, and appraise the internal validity and certainty of evidence using GRADE methodology. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 and the Cochrane Handbook. Studies included randomized controlled trials and prospective comparative studies assessing interventions such as biological dressings, nutritional supplements, and adjunctive technologies for chronic wounds in older adults. Primary outcomes included wound closure and healing time; secondary outcomes included pain, wound size reduction, and cost-effectiveness. Risk of bias was assessed using RoB 2 and ROBINS-I tools. Results: Of 276 records screened, 8 studies were included; 3 were eligible for meta analysis. Pharmacist-relevant interventions such as honey, silicone, and acellular dermal matrix (ADM) dressings significantly improved complete wound healing (pooled RR = 2.66; 95% CI: 1.88–3.76; high certainty). Nutritional supplementation accelerated healing (MD ranging from 6 to 22 days faster) and showed economic benefits ($881 saved/patient), though with low certainty. Pain and wound size reduction outcomes also favored intervention groups. Conclusion: Pharmacist-relevant interventions, particularly biological dressings and nutritional strategies, demonstrate clinically and economically meaningful benefits in elderly wound care. These findings support the integration of pharmacists into geriatric wound management protocols and highlight the need for geriatric-specific, high-quality trials.
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