Nurses' role in deprescribing for older adults: A scoping review

To map the evidence on nurses' roles and contributions in deprescribing within the multidisciplinary team across all clinical settings.

This scoping review was conducted using Arksey and O'Malley's framework and the Joanna Briggs Institute (JBI) methodology, and reported by the PRISMA-ScR 2020 checklist. A systematic search was conducted across CINAHL, Embase, MEDLINE (Ovid), Web of Science, Scopus and Google Scholar, with no time restrictions. Studies in English and Italian were included if they explored the role of nurses in deprescribing in older adults (≥65 years) across hospital, home, or community settings. A wide range of study designs was considered, including empirical studies, reviews, and gray literature.

28 studies were included in the review. Nurses played key roles in deprescribing through medication review, adherence assessment, detection of adverse drug effects or drug-drug interactions, patient education, and monitoring. Nurse-led interventions, conducted independently or in collaboration with the multidisciplinary team, were effective in reducing potentially inappropriate medications and improving adherence as primary outcomes. Key facilitators of nurses' views on deprescribing included strong interdisciplinary collaboration, training, and use of decision-support tools. Limited resources, a lack of trust in medication counseling, fragmented care, and patient-related difficulties were the main obstacles.

The changing and crucial role that nurses play in the deprescribing process is highlighted in this scoping review. The medication safety of older adults necessitates empowering nurses through organizational frameworks, technology support, and training. There is a clear need for stronger, high-quality evidence, including randomized controlled trials and rigorously designed implementation studies, to assess outcomes and guide the integration of nurse-led deprescribing interventions into everyday clinical practice.

Protocol registered on the Open Science Framework (doi:10.17605/OSF.IO/C49BU).