Evaluating the impact of medication review and deprescribing on prescribing appropriateness and clinical outcomes in older people residing in long-term care facilities: a systematic review and meta-analysis.
Background Polypharmacy is a major concern among older adults in long-term care facilities (LTCFs), as it increases the risk of potentially inappropriate medications (PIMs) and related adverse outcomes. Medication review and deprescribing interventions may help optimise therapy and reduce harm. Desi...
| Publicado en: | Age & Ageing Vol. 55; no. 4; pp. 1 - 16 |
|---|---|
| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Apr2026
|
| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=193500080&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 193500080 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Apr2026 vid: 55 iid: 4 pid: 622 pub: Oxford University Press / USA artinfo: ui: 193500080 10.1093/ageing/afag084 ppf: 1 ppct: 15 formats: tig: atl: Evaluating the impact of medication review and deprescribing on prescribing appropriateness and clinical outcomes in older people residing in long-term care facilities: a systematic review and meta-analysis. aug: au: Carollo, Massimo Cristini, Irene Crisafulli, Salvatore Fontana, Andrea Forti, Anna Lanaro, Aurora Maccarrone, Francesco Zerio, Marta Piccoli, Luca Poluzzi, Elisabetta affil: Department of Diagnostics and Public Health, University of Verona, Verona, 37134, Veneto, Italy IRCCS Ospedale Casa Sollievo della Sofferenza, Unit of Biostatistics, San Giovanni Rotondo, 71013 Apulia, Italy Department of Medical and Surgical Sciences, University of Bologna, Bologna, 40138, Emilia-Romagna, Italy su: Mortality Hospital care Patient care Nursing care facilities Inappropriate prescribing (Medicine) Medical information storage & retrieval systems Medication error prevention Deprescribing Meta-analysis Polypharmacy Descriptive statistics Systematic reviews MEDLINE Online information services Confidence intervals Data analysis software Accidental falls sug: subj: Mortality Hospital care Patient care Nursing care facilities Nursing Care Facilities (Skilled Nursing Facilities) Community care facilities for the elderly Inappropriate prescribing (Medicine) Medical information storage & retrieval systems Medication error prevention Deprescribing Meta-analysis Polypharmacy Descriptive statistics Systematic reviews MEDLINE Online information services Confidence intervals Data analysis software Accidental falls keyword: appropriateness copyrightHolder:British Geriatrics Society copyrightYear:2026 deprescribing https://dx.doi.org/10.1093/ageing/afag084 inLanguage:en long-term care long-term care facilities medication review mortality older adult older people patient-centred care polypharmacy prescribing behavior publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/41967033/ systematic review treatment outcome appropriateness copyrightHolder:British Geriatrics Society copyrightYear:2026 deprescribing https://dx.doi.org/10.1093/ageing/afag084 inLanguage:en long-term care long-term care facilities medication review mortality older adult older people patient-centred care polypharmacy prescribing behavior publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/41967033/ systematic review treatment outcome ab: Background Polypharmacy is a major concern among older adults in long-term care facilities (LTCFs), as it increases the risk of potentially inappropriate medications (PIMs) and related adverse outcomes. Medication review and deprescribing interventions may help optimise therapy and reduce harm. Design Systematic review and meta-analysis. Methods This study was conducted according to PRISMA guidelines (PROSPERO: CRD42023486056). PubMed, Embase and Scopus were searched up to 27 August 2024, for experimental studies evaluating the impact of medication review/deprescribing interventions in older LTCF residents with polypharmacy. Outcomes included medication appropriateness indexes, falls, hospitalisations and mortality. We calculated risk ratios for dichotomous data and mean differences for continuous data [with 95% confidence intervals (CIs)]. The quality of the studies was assessed using RoB 2 for the randomised controlled trials (RCTs) and the ROBINS-I for non-randomised studies. Results From 3548 records, 38 studies (22 RCTs, 16 quasi-experimental) were included. Pooled analyses demonstrated significant reductions in the number of drugs per patient [within 12 months: −0.89 (95% CI −1.46, −0.32); at ≥12 months: −1.60 (95% CI −2.68, −0.52)] and in PIMs [at 6 months: −0.48 (95% CI −0.74, −0.22); at ≥12 months: −0.26 (95% CI −0.40, −0.13)]. No significant effects were observed on falls, hospitalisations or mortality. Studies showed wide methodological heterogeneity and had moderate to high risk of bias (23 moderate, 14 high, 1 low). Conclusions Comprehensive medication review interventions improved prescribing appropriateness in older LTCF residents with polypharmacy but did not significantly affect clinical outcomes (i.e. falls, hospitalisations and mortality). Further high-quality studies using standardised approaches are needed. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
|---|