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Validated medication deprescribing instruments for patients with palliative care needs: a systematic review
Frangie Kallas de Andrade1, Raziel Prado Ignacio Nunes1, Maria Olívia Barboza Zanetti2
1University of São Paulo (USP), School of Pharmaceutical Sciences of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.
Summary
Deprescribing tools can reduce inappropriate medications and costs for older adults with limited life expectancy. However, their impact on patient safety and quality of life requires further investigation.
Area of Science:
- Gerontology
- Pharmacology
- Palliative Care
Background:
- Polypharmacy is common in patients with life-limiting illnesses, increasing risks.
- Deprescribing tools aim to mitigate negative outcomes associated with excessive medication use.
Purpose of the Study:
- Identify validated deprescribing instruments for palliative care patients.
- Assess the impact of deprescribing on clinical, humanistic, and economic outcomes.
Main Methods:
- A systematic review of multiple databases (LILACS, PubMed, EMBASE, Cochrane, Web of Science) was conducted.
- Included studies were experimental or observational, with manual reference searches.
- Two independent researchers performed screening, eligibility, extraction, and bias risk assessment.
Main Results:
- Only one study met inclusion criteria, a randomized controlled trial with high overall bias risk.
- The STOPPFrail tool in the intervention group significantly reduced inappropriate medications and monthly costs.
- No significant differences were observed in hospital presentations, falls, fractures, mortality, or quality of life.
Conclusions:
- The STOPPFrail tool shows potential for reducing inappropriate medications and costs in older adults with limited life expectancy.
- Limited evidence exists for validated deprescribing tools in clinical practice for palliative care.
- Further research is needed to clarify the impact on patient safety and humanistic outcomes.
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