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 safety, clinical impact, and long-term
outcomes of deprescribing services in frail patients, including the
barriers and enablers of deprescribing services in such settings.
Methods: A systematic review was performed in Scopus, CINAHL PLUS
(EBSCO), MEDLINE (OVID and EMBASE) and Cochrane library. The Mixed
Methods Appraisal tool (MMAT) 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: 590 unique titles were identified, with 9 (6 trials, 1
interview, 1 survey, and 1 designed-delay study) meeting inclusion and
exclusion criteria. Five mains descriptive themes have been identified:
barriers, enablers, deprescribing services in frailty, safety management
and deprescribing outcomes. Conclusion: This study provides limited
evidence that deprescribing services in frail patients are effective in
reducing the number of potentially inappropriate medications and
medication costs. To further improve deprescribing in frailty,
clinicians should consider a customised safety plan and benefit/risk
assessment for each patient.