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Deprescribing To Reduce Medication Harms in Older Adults

Rapid Evidence Product Feb 1, 2024
Download the file for this report here.

  • Deprescribing has emerged as a clinical practice to reduce polypharmacy and use of potentially inappropriate medications (PIMs) and serve as a mechanism for quality improvement and increased patient safety. The purpose of this rapid response is to summarize recent literature on the use of deprescribing to improve the safety of medication use among older adults (age ≥ 65 years).
  • Our literature search identified 15 systematic reviews and 7 original research studies published since 2019 that evaluated the effectiveness of deprescribing interventions in improving outcomes. All but one of the original research studies was a randomized trial.
  • Deprescribing interventions included, but were not limited to, comprehensive medication reviews, patient education, provider education, and clinical decision support systems. Studies were conducted in healthcare settings across the care continuum, including outpatient clinics, emergency departments, acute care hospitals, long-term care facilities, and community pharmacies. Pharmacists were commonly included in interventions.
  • Due to heterogeneity, few systematic reviews were able to quantitatively synthesize findings. Combined with findings from the original research studies, deprescribing in general decreased number of medications or potentially inappropriate medications. Clinical outcomes were more variable, with conflicting findings or non-statistically significant results. Few adverse drug withdrawal events resulted from deprescribing interventions.
  • There is a large body of literature about barriers and facilitators to implementation of deprescribing interventions. Potentially influential facilitators include agreement by both the patient and the clinician to deprescribe, a standardized process for deprescribing, a strong culture/motivation to reduce medication use, and interprofessional team involvement.

Linsky AM, Motala A, Lawson E, Shekelle P. Making Healthcare Safer IV: Deprescribing To Reduce Medication Harms in Older Adults. Rapid Response. (Prepared by the Southern California Evidence-based Practice Center under Contract No. 75Q80120D00003). AHRQ Publication No. 23(24)-EHC019-8. Rockville, MD: Agency for Healthcare Research and Quality. February 2024. https://doi.org/10.23970/AHRQEPC_MHS4DEPRESCRIBING. Posted final reports are located on the Effective Health Care Program search page.

Project Timeline

Making Healthcare Safer IV: Deprescribing to Reduce Medication Harms in Older Adults

Aug 31, 2023
Topic Initiated
Sep 5, 2023
Feb 1, 2024
Rapid Evidence Product
Page last reviewed February 2024
Page originally created February 2024

Internet Citation: Rapid Evidence Product: Deprescribing To Reduce Medication Harms in Older Adults. Content last reviewed February 2024. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD.

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