Evaluation of deprescribing services in frail patients: a systematic review
Alshatti, Dalal Cox, Anthony R Hirsch, Christine Cheng, Vicky Aston, Jeff
Alshatti, Dalal
Cox, Anthony R
Hirsch, Christine
Cheng, Vicky
Aston, Jeff
Affiliation
University of Birmingham; University Hospitals Birmingham NHS Foundation Trust
Other Contributors
Publication date
2024-11-30
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Background: Deprescribing, a process of dose reduction or withdrawal of inappropriate medication that no longer has benefit, is a proposed intervention in the care of older adults living with frailty.
Objective/aim: To evaluate the safety, effectiveness, and clinical impact of deprescribing services in frail patients.
Methods: A systematic literature search was performed in November 2023 using Scopus, CINAHL PLUS (EBSCO), MEDLINE (OVID and EMBASE), and Cochrane Library. The Mixed Methods Appraisal tool was used for appraising the methodological quality of the included papers. Studies were selected after title, abstract, and full-text screening, with independent review. Thematic analysis was used for analysing data from the selected articles.
Results: Five hundred ninety unique titles were identified, with nine (six trials, one interview, one survey, and one designed-delay study) meeting inclusion and exclusion criteria. Four main descriptive themes have been identified: challenges of deprescribing in frailty, facilitators of deprescribing in frailty, deprescribing processes in current practice in frail patients, and deprescribing outcomes. Additionally, two analytical themes have been identified: safety and quality.
Conclusion: A number of issues have been highlighted that impact the implementation of deprescribing services in frail patients. Currently, there is limited evidence showing strong benefits of such deprescribing services, such as reducing the number of potentially inappropriate medications and medication costs.
Citation
Alshatti D, Cox AR, Hirsch C, Cheng V, Aston J. Evaluation of deprescribing services in frail patients: a systematic review. Int J Pharm Pract. 2025 Feb 7;33(1):34-44. doi: 10.1093/ijpp/riae070.
Type
Article