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Tools and guidelines to assess the appropriateness of medication and aid the deprescribing: an umbrella review
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  • Degefaye Anlay,
  • Kristel Paque,
  • Ellen Van Leeuwen ,
  • Joachim Cohen,
  • Tinne Dilles
Degefaye Anlay
Vrije Universiteit Brussel

Corresponding Author:[email protected]

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Kristel Paque
University of Antwerp
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Ellen Van Leeuwen
Ghent University
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Joachim Cohen
Vrije Universiteit Brussel
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Tinne Dilles
University of Antwerp
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AIMS The aim of this umbrella review was to identify tools and guidelines available to aid the deprescribing process of potentially inappropriate medications (PIM), evaluate their methods of development and validation, and describe at what level of evidence medications are included in the tools and guidelines. METHODS Searches were conducted on MEDLINE(Ovid), Embase.com, Cochrane CDSR, CINAHL (EBSCO), Web of Science Core Collection, and guideline databases from the date of inception to July 7, 2022. We described and compared the different characteristics and contents of tools and guidelines. RESULTS From 10,606 records screened, 23 systematic reviews and guidelines met the inclusion criteria. We then identified 90 tools (67 explicit, 12 mixed, 11 implicit), and 9 guidelines. The majority were developed for use in older adults (n = 74). Nineteen tools targeted older adults with limited life expectancy (LLE), and 7 targeted children <18 years. The majority (97%) of explicit/mixed tools were validated through Delphi techniques (n = 61). Two tools and eight guidelines provided information on the level of evidence for the included medications, of which less than a quarter were included based on high-quality evidence. CONCLUSION Existing tools are available for a diversity of populations. Discrepancies identified in categorizing medications as appropriate or not can be a result of low quality evidence. Particularly, tools for patients with LLE were developed based on very limited evidence, and research to generate this evidence is highly needed. Our medication lists, along with the level of evidence, could facilitate efforts to strengthen the evidence.
26 Mar 2023Submitted to British Journal of Clinical Pharmacology
26 Mar 2023Submission Checks Completed
26 Mar 2023Assigned to Editor
26 Mar 2023Review(s) Completed, Editorial Evaluation Pending
04 Jun 2023Reviewer(s) Assigned
01 Jul 2023Editorial Decision: Revise Major
24 Aug 20231st Revision Received
24 Aug 2023Submission Checks Completed
24 Aug 2023Assigned to Editor
24 Aug 2023Review(s) Completed, Editorial Evaluation Pending
29 Aug 2023Editorial Decision: Accept