Evidence map›Paper›PMID 27077231›Full record

SynthesisBritish journal of clinical pharmacology2016

The feasibility and effect of deprescribing in older adults on mortality and health: a systematic review and meta-analysis.

Amy T Page, Rhonda M Clifford, Kathleen Potter, Darren Schwartz, Christopher D Etherton-Beer

5 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of clinical pharmacology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 212 papers, 29 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
212citing papers in PubMed, 29 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03283735 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Deprescribing: a Portrait and Out-comes of the Reduction of Polypharmacy in Portugal

TypeinterventionalSponsorUniversity of Beira InteriorRan2019 to 2020Enrolled380ConditionsPolypharmacy, DeprescriptionsArmsElderly Enablement
NCT03689049 naactive not recruitingnot on this mapstarted 2018, after this paper: background citation

SPIDER: A Structured Process Informed by Data, Evidence and Research - A Research and Quality Improvement Collaboration Supporting Practices in Improving Care for Complex Elderly Patients

TypeinterventionalSponsorUniversity of Toronto Practice Based Research NetworkRan2018 to 2027Enrolled104ConditionsPolypharmacy, Inappropriate Prescribing, Aged, Primary Health CareArmsSPIDER, Usual Care
NCT03824106 narecruitingnot on this mapstarted 2022, after this paper: background citation

Frailty Rehabilitation: A Community-based Intervention to Promote Healthy Aging

TypeinterventionalSponsorMcMaster UniversityRan2022 to 2025Enrolled324ConditionsFrailtyArmsControl, Group Exercise, Nutrition and Medication review, Protein Supplement, Vitamin D
NCT06212713 unknown statusnot on this mapstarted 2023, after this paper: background citation

Development and Validation of a Health Behaviour Theory-based Questionnaire to Explore the Willingness of Older Adults and Informal Caregivers to Deprescribe

TypeobservationalSponsorUniversité Catholique de LouvainRan2023 to 2024Enrolled600ConditionsPsychologicalArmsQuestionnaire administration
NCT06335953 nacompletednot on this mapstarted 2024, after this paper: background citation

Demonstration of ALIGN: Aligning Medications With What Matters Most

TypeinterventionalSponsorJohns Hopkins UniversityRan2024 to 2025Enrolled474ConditionsPolypharmacy, Alzheimer's Disease and Related Dementias, Mild Cognitive ImpairmentArmsPharmacist-led deprescribing intervention
3 · Its place in the literature

Who cites it

212 citing papers in PubMed, 29 syntheses or guidelines pooled it.

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  5. Withdrawal of antihypertensive drugs in older people.The Cochrane database of systematic reviews · 2025
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  7. [PAPPS update on older people 2024].Atencion primaria · 2024
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  12. Consumer Attitudes Towards Deprescribing: A Systematic Review and Meta-Analysis.The journals of gerontology. Series A, Biological sciences and medical sciences · 2022
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152 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Amy T PageSchool of Medicine and Pharmacology, University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia, Australia.ORCID 0000-0002-2084-8469
Rhonda M CliffordSchool of Medicine and Pharmacology, University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia, Australia.
Kathleen PotterSchool of Medicine and Pharmacology, University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia, Australia.
Darren SchwartzSchool of Medicine and Pharmacology, University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia, Australia.
Christopher D Etherton-BeerSchool of Medicine and Pharmacology, University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia, Australia.ORCID 0000-0001-5148-0188

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsDeprescribing is a suggested intervention to reverse the potential iatrogenic harms of inappropriate polypharmacy. The review aimed to determine whether or not deprescribing is a safe, effective and feasible intervention to modify mortality and health outcomes in older adults.

methodsSpecified databases were searched from inception to February 2015. Two researchers independently screened all retrieved articles for inclusion, assessed study quality and extracted data. Data were pooled using RevMan v5.3. Eligible studies included those where older adults had at least one medication deprescribed. The primary outcome was mortality. Secondary outcomes were adverse drug withdrawal events, psychological and physical health outcomes, quality of life, and medication usage (e.g. successful deprescribing, number of medications prescribed, potentially inappropriate medication use).

resultsA total of 132 papers met the inclusion criteria, which included 34 143 participants aged 73.8 ± 5.4 years. In nonrandomized studies, deprescribing polypharmacy was shown to significantly decrease mortality (OR 0.32, 95% CI: 0.17-0.60). However, this was not statistically significant in the randomized studies (OR 0.82, 95% CI 0.61-1.11). Subgroup analysis revealed patient-specific interventions to deprescribe demonstrated a significant reduction in mortality (OR 0.62, 95% CI 0.43-0.88). However, generalized educational programmes did not change mortality (OR 1.21, 95% CI 0.86-1.69).

conclusionsAlthough nonrandomized data suggested that deprescribing reduces mortality, deprescribing was not shown to alter mortality in randomized studies. Mortality was significantly reduced when applying patient-specific interventions to deprescribe in randomized studies.

Indexed as

DeprescriptionsHumansInappropriate PrescribingPolypharmacydeprescribingmedication discontinuationmeta-analysisolder adultspolypharmacysystematic review

Identifiers

PMID27077231
PMCPMC5338123

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.