Deprescribing Interventions for Older Patients: A Systematic Review and Meta-Analysis

Link to article at PubMed

J Am Med Dir Assoc. 2023 Aug 12:S1525-8610(23)00645-X. doi: 10.1016/j.jamda.2023.07.016. Online ahead of print.


OBJECTIVES: Deprescribing reduces polypharmacy in older adults. A thorough study of the effect of deprescribing interventions on clinical outcomes in older adults is presently lacking. As a result, we evaluated the impact of deprescribing on clinical outcomes in older patients.

DESIGN: Meta-analysis and systematic review of randomized controlled trials (RCTs). PubMed, EMBASE, and Cochrane Library were searched from the time of creation to March 2023.

SETTING AND PARTICIPANTS: Randomized controlled trial with participants at least 60 years old.

MEASURES: Mortality, falls (number of fallers), hospitalization rates, emergency department visits, medication adherence, HRQoL (health-regulated quality of life), incidence of ADR (adverse drug reactions), PIM (potentially inappropriate medication), and PPO (potentially prescription omission) were evaluated in the meta-analysis.

RESULTS: A total of 32 RCTs (18,670 patients) were included. Deprescribing interventions significantly reduced proportions of older adults with PIM, PPO, and the incidence of ADRs. The interventions group also improved medication compliance.

CONCLUSIONS AND IMPLICATIONS: Compared to routine care, deprescribing interventions significantly improve clinical outcome indicators for older adults.

PMID:37582482 | DOI:10.1016/j.jamda.2023.07.016

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