Dalal Alshatti, Anthony R Cox, Christine Hirsch, Vicky Cheng, Jeff Aston
{"title":"Evaluation of deprescribing services in frail patients: a systematic review.","authors":"Dalal Alshatti, Anthony R Cox, Christine Hirsch, Vicky Cheng, Jeff Aston","doi":"10.1093/ijpp/riae070","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective/aim: </strong>To evaluate the safety, effectiveness, and clinical impact of deprescribing services in frail patients.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":14284,"journal":{"name":"International Journal of Pharmacy Practice","volume":" ","pages":"34-44"},"PeriodicalIF":1.5000,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Pharmacy Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ijpp/riae070","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
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.
背景：开处方是一种减少剂量或停用不再有益处的不适当药物的过程，是一种建议的老年人虚弱护理干预措施。目的：评价体弱多病患者处方化服务的安全性、有效性和临床影响。方法：于2023年11月使用Scopus、CINAHL PLUS （EBSCO）、MEDLINE （OVID和EMBASE）和Cochrane Library进行系统文献检索。采用混合方法评价工具对纳入论文的方法学质量进行评价。研究经过标题、摘要和全文筛选，并进行独立审查。专题分析用于分析所选文章的数据。结果：确定了590个独特的标题，其中9个（6个试验、1个访谈、1个调查和1个设计延迟研究）符合纳入和排除标准。已经确定了四个主要的描述主题：虚弱时开处方的挑战，虚弱时开处方的促进因素，虚弱患者当前实践中的开处方过程，以及开处方的结果。此外，还确定了两个分析主题：安全和质量。结论：一些问题已被强调，影响到在体弱患者中实施处方服务。目前，有有限的证据表明这种减少处方服务的强大好处，例如减少潜在不适当药物的数量和药物费用。
期刊介绍：
The International Journal of Pharmacy Practice (IJPP) is a Medline-indexed, peer reviewed, international journal. It is one of the leading journals publishing health services research in the context of pharmacy, pharmaceutical care, medicines and medicines management. Regular sections in the journal include, editorials, literature reviews, original research, personal opinion and short communications. Topics covered include: medicines utilisation, medicine management, medicines distribution, supply and administration, pharmaceutical services, professional and patient/lay perspectives, public health (including, e.g. health promotion, needs assessment, health protection) evidence based practice, pharmacy education. Methods include both evaluative and exploratory work including, randomised controlled trials, surveys, epidemiological approaches, case studies, observational studies, and qualitative methods such as interviews and focus groups. Application of methods drawn from other disciplines e.g. psychology, health economics, morbidity are especially welcome as are developments of new methodologies.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
