Accepted for/Published in: JMIR Research Protocols
Date Submitted: Oct 21, 2020
Date Accepted: Sep 3, 2021
Health impacts and characteristics of deprescribing interventions in older adults; a protocol of a systematic review and meta-analysis
ABSTRACT
Background:
Deprescribing, a relatively recent concept, has been proposed as a promising solution to the growing issues of polypharmacy and use of medications of questionable benefit among older adults. However, little is known about the health outcomes of deprescribing interventions.
Objective:
This study aims to contribute to the knowledge on deprescribing by addressing two specific objectives: 1) describe the impact of deprescribing in adults’ ≥60 years on health outcomes or quality of life; and 2) determine the characteristics of effective interventions in deprescribing.
Methods:
Primary studies targeting three concepts (older adults, deprescribing, and health/quality of life outcomes) will be included in the review. The search will be performed using key international databases (MEDLINE, EMBASE, CINAHL, Ageline, PsycInfo) and a special effort will be made to identify grey literature. Two reviewers will independently screen the articles, extract the information and evaluate the quality of the selected studies. If methodologically feasible, meta-analyses will be performed for groups of intervention studies reporting on deprescribing interventions for similar medications, used for similar or identical indications and reporting on similar outcomes (for example benzodiazepines used against insomnia and reporting on quality of sleep or quality of life). Alternatively, results will be presented in bottom-line statements (Objectives 1) and a matrix outlining effective interventions (Objective 2).
Results:
The knowledge synthesis may be limited by the availability of high-quality, clinical trials on deprescribing and its outcomes in older adults. Additionally, analyses will likely be affected by studies on the deprescribing of different types of molecules within the same indication, e.g. different pharmacological classes and medications to treat hypertension, and different measures of health and quality of life outcomes for the same indication.
Conclusions:
Deprescribing becomes more widespread, therefore knowledge on its effects on health are needed. Clinical Trial: CRD42015020866
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