Deprescribing interventions, which aim to identify and reduce potentially inappropriate prescribing (PIP) in older adults with multiple chronic conditions, have been shown to be feasible and generally safe. However, the impact on patient outcomes remains unclear.
A review of 118 randomized clinical trials involving over 400,000 patients found that deprescribing efforts led to a modest reduction in prescriptions – about half a medication per person on average. The study’s authors suggest that PIP interventions may be implemented to safely reduce the number of medications prescribed to older adults in primary care settings.
The analysis broke down into two categories: broad general medication reviews and explicit interventions focused on avoiding high-risk drugs. While both types of interventions led to a decrease in medication counts, there were no consistent signs of clinical benefit. However, some studies suggested that explicit interventions might lower hospitalization risk, albeit with small and variable effects.
The study confirms deprescribing is generally safe but highlights the need for further research using standardized tools to measure outcomes and capture subtler benefits. Reducing medications may not necessarily reduce hospital visits or improve survival, but it could improve how patients feel, function, and manage their health.
This new analysis offers hope that deprescribing can be used to safely reduce medication burden in older adults without causing harm. However, more research is needed to fully understand the impact of these interventions on patient outcomes.
Source: https://www.medicaleconomics.com/view/older-patients-are-overprescribed-cutting-back-is-safe-but-results-may-fall-short