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Study protocol for developing deprescribing clinical practice guidelines: evidence-based GRADE methodology and a

Hui Wen Quek1, Amy Page2, Kenneth Lee2

  • 1Centre for Optimisation of Medicines, School of Allied Health, The University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia, 6009, Australia. amanda.quek@research.uwa.edu.au.

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Summary
This summary is machine-generated.

This protocol details developing evidence-based deprescribing guidelines for older adults using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology and Delphi consensus. The guidelines aim to reduce inappropriate medicine use in elderly patients.

Keywords:
AgedClinical decision-makingDelphi techniqueDrug utilizationGeriatric medicine

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Area of Science:

  • Geriatric Medicine
  • Pharmacology
  • Evidence-Based Practice

Background:

  • Deprescribing is crucial for reducing potentially inappropriate medicine use in older adults.
  • Clinical practice guidelines are essential for integrating deprescribing into routine care.
  • This protocol focuses on developing guidelines for commonly prescribed medicines in the elderly.

Purpose of the Study:

  • To outline the development of evidence-based deprescribing clinical practice guidelines for older people.
  • To apply the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology.
  • To utilize a Delphi consensus-building process for recommendation development.

Main Methods:

  • Adherence to World Health Organisation and Australian National Health and Medical Research Council guideline development standards.
  • A two-part approach: systematic review/meta-analysis using GRADE and a modified Delphi method for consensus.
  • Involvement of a multidisciplinary team, professional organizations, and patient/carer stakeholders.

Main Results:

  • A comprehensive systematic review and meta-analysis will identify and assess evidence using the GRADE framework.
  • Evidence-based recommendations will be formulated where quality evidence exists.
  • Consensus-based recommendations and good practice statements will be developed for areas with limited evidence.

Conclusions:

  • The protocol adapts established methodologies to address practical, operational, and resource considerations for guideline development.
  • Expert consensus and patient input are vital for developing recommendations in this emerging field with limited evidence.
  • The final guidelines will offer comprehensive support for deprescribing common medicines in older adults, complementing existing resources.