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Implementation considerations of deprescribing interventions: A scoping review
Jinjiao Wang1, Jenny Y Shen2, Yeates Conwell3
1Elaine, Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester, Rochester, New York, USA.
Journal of Internal Medicine
|December 16, 2022
Summary
Deprescribing, the reduction of unnecessary medications, effectively addresses polypharmacy in older adults. Future research must balance intervention effectiveness with practical implementation in routine care.
Area of Science:
- Gerontology
- Pharmacology
- Health Services Research
Background:
- Polypharmacy affects over half of older adults, involving inappropriate or unnecessary medications.
- Deprescribing offers an effective strategy to mitigate polypharmacy and its associated risks.
Purpose of the Study:
- To review deprescribing processes, models, tools, and facilitators.
- To examine barriers, enablers, and factors influencing deprescribing.
- To analyze deprescribing interventions and implementation considerations for routine practice.
Main Methods:
- Systematic review of deprescribing literature.
- Analysis of conceptual models and developed tools for deprescribing.
- Evaluation of completed deprescribing intervention trials and implementation strategies.
Main Results:
- Multilevel factors (patient, clinician, system) impact deprescribing efficacy.
- Existing deprescribing tools often demand significant time, hindering routine implementation.
- Interventions commonly include patient education, medication review, and communication, but lack implementation focus.
Conclusions:
- Effective deprescribing requires addressing patient, clinician, and health system factors.
- Implementation challenges, including time constraints and resource integration, need greater attention.
- Future deprescribing trials should prioritize a balanced approach to effectiveness and implementation feasibility.
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