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Review of structured guides for deprescribing
Ian Scott1,2, Kristen Anderson2, Christopher Freeman3
1Department of Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Summary
Deprescribing guides help reduce inappropriate polypharmacy in older adults. However, evidence of their effectiveness is limited, with more research needed for routine clinical practice.
Area of Science:
- Gerontology
- Pharmacology
- Patient Safety
Background:
- Polypharmacy is a significant safety concern in older patients.
- Deprescribing involves reviewing medications to identify unfavorable risk-benefit trade-offs.
- Structured guides aim to assist clinicians in medication discontinuation decisions.
Purpose of the Study:
- To review seven structured deprescribing guides designed to reduce polypharmacy.
- To assess the design, content, and efficacy testing of these guides.
Main Methods:
- Narrative review of seven structured deprescribing guides.
- Guides were selected based on their purpose to reduce polypharmacy and undergo efficacy testing.
Main Results:
- Significant heterogeneity exists in the design and content of the reviewed guides.
- Evidence of effectiveness is limited, with no randomized controlled trials conducted.
- Studies involved small patient samples, lacked reliability testing, and were mostly hospital-based.
Conclusions:
- Most deprescribing guides show face validity but require further research.
- Effectiveness and ease of use in routine primary care settings remain unknown.
- Head-to-head comparisons are needed to determine the most useful guides for clinicians.
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