PMID- 34889771
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220111
IS  - 1929-0748 (Print)
IS  - 1929-0748 (Electronic)
IS  - 1929-0748 (Linking)
VI  - 10
IP  - 12
DP  - 2021 Dec 9
TI  - Health Impacts and Characteristics of Deprescribing Interventions in Older 
      Adults: Protocol for a Systematic Review and Meta-analysis.
PG  - e25200
LID - 10.2196/25200 [doi]
LID - e25200
AB  - 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 paper presents 
      the protocol of a study that 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 or 
      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 gray 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 (eg, benzodiazepines 
      used against insomnia and studies reporting on quality of sleep or quality of 
      life). Alternatively, the results will be presented in bottom-line statements 
      (objective 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 their outcomes in older adults. 
      Additionally, analyses will likely be affected by studies on the deprescribing of 
      different types of molecules within the same indication (eg, different 
      pharmacological classes and medications to treat hypertension) and different 
      measures of health and quality of life outcomes for the same indication. 
      Nevertheless, we expect the review to identify which deprescribing interventions 
      lead to improved health outcomes among seniors and which of their characteristics 
      contribute to these outcomes. CONCLUSIONS: This systematic review will contribute 
      to a better understanding of the health outcomes of deprescribing interventions 
      among seniors. TRIAL REGISTRATION: PROSPERO International Prospective Register of 
      Systematic Reviews CRD42015020866; 
      https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42015020866. 
      INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/25200.
CI  - (c)Zoe Tremblay, David Mumbere, Danielle Laurin, Caroline Sirois, Daniela Furrer, 
      Lise Poisblaud, Pierre-Hugues Carmichael, Barbara Farrell, Andre Tourigny, Anik 
      Giguere, Isabelle Vedel, Jose Morais, Edeltraut Kroger. Originally published in 
      JMIR Research Protocols (https://www.researchprotocols.org), 09.12.2021.
FAU - Tremblay, Zoe
AU  - Tremblay Z
AUID- ORCID: 0000-0003-3194-3688
AD  - Faculte de pharmacie, Universite Laval, Quebec, QC, Canada.
FAU - Mumbere, David
AU  - Mumbere D
AUID- ORCID: 0000-0002-6746-9300
AD  - Faculte de pharmacie, Universite Laval, Quebec, QC, Canada.
FAU - Laurin, Danielle
AU  - Laurin D
AUID- ORCID: 0000-0001-5032-2452
AD  - Faculte de pharmacie, Universite Laval, Quebec, QC, Canada.
FAU - Sirois, Caroline
AU  - Sirois C
AUID- ORCID: 0000-0003-3294-7883
AD  - Faculte de pharmacie, Universite Laval, Quebec, QC, Canada.
FAU - Furrer, Daniela
AU  - Furrer D
AUID- ORCID: 0000-0002-1497-1831
AD  - Centre d'excellence sur le vieillissement de Quebec, Centre integre universitaire 
      de sante et de services sociaux de la Capitale Nationale, Quebec, QC, Canada.
FAU - Poisblaud, Lise
AU  - Poisblaud L
AUID- ORCID: 0000-0001-9737-7178
AD  - Centre d'excellence sur le vieillissement de Quebec, Centre integre universitaire 
      de sante et de services sociaux de la Capitale Nationale, Quebec, QC, Canada.
FAU - Carmichael, Pierre-Hugues
AU  - Carmichael PH
AUID- ORCID: 0000-0002-5324-862X
AD  - Centre d'excellence sur le vieillissement de Quebec, Centre integre universitaire 
      de sante et de services sociaux de la Capitale Nationale, Quebec, QC, Canada.
FAU - Farrell, Barbara
AU  - Farrell B
AUID- ORCID: 0000-0002-2388-5353
AD  - Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
FAU - Tourigny, Andre
AU  - Tourigny A
AUID- ORCID: 0000-0002-2447-8848
AD  - Faculte de medecine, Universite Laval, Quebec, QC, Canada.
FAU - Giguere, Anik
AU  - Giguere A
AUID- ORCID: 0000-0001-9928-7395
AD  - Faculte de medecine, Universite Laval, Quebec, QC, Canada.
FAU - Vedel, Isabelle
AU  - Vedel I
AUID- ORCID: 0000-0002-6873-1681
AD  - Faculty of Medicine, McGill University, Montreal, QC, Canada.
FAU - Morais, Jose
AU  - Morais J
AUID- ORCID: 0000-0001-9366-6626
AD  - Faculty of Medicine, McGill University, Montreal, QC, Canada.
FAU - Kroger, Edeltraut
AU  - Kroger E
AUID- ORCID: 0000-0002-5653-3979
AD  - Faculte de pharmacie, Universite Laval, Quebec, QC, Canada.
AD  - Centre d'excellence sur le vieillissement de Quebec, Centre integre universitaire 
      de sante et de services sociaux de la Capitale Nationale, Quebec, QC, Canada.
AD  - Faculty of Medicine, McGill University, Montreal, QC, Canada.
LA  - eng
PT  - Journal Article
DEP - 20211209
PL  - Canada
TA  - JMIR Res Protoc
JT  - JMIR research protocols
JID - 101599504
PMC - PMC8704115
OTO - NOTNLM
OT  - aging
OT  - comorbidity
OT  - deprescribing
OT  - inappropriate prescribing
OT  - medication use
OT  - multimorbidity
OT  - older adult
OT  - polypharmacy
OT  - potentially inappropriate medication
OT  - systematic review
COIS- Conflicts of Interest: None declared.
EDAT- 2021/12/11 06:00
MHDA- 2021/12/11 06:01
PMCR- 2021/12/09
CRDT- 2021/12/10 12:17
PHST- 2020/10/21 00:00 [received]
PHST- 2021/09/03 00:00 [accepted]
PHST- 2021/08/05 00:00 [revised]
PHST- 2021/12/10 12:17 [entrez]
PHST- 2021/12/11 06:00 [pubmed]
PHST- 2021/12/11 06:01 [medline]
PHST- 2021/12/09 00:00 [pmc-release]
AID - v10i12e25200 [pii]
AID - 10.2196/25200 [doi]
PST - epublish
SO  - JMIR Res Protoc. 2021 Dec 9;10(12):e25200. doi: 10.2196/25200.