ArticleDrugs & aging2026
Pharmacist-Led Deprescribing Interventions for Older Adults with Polypharmacy: A Retrospective Cohort Study of Community Pharmacy Practice in Japan.
Article in Drugs & aging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
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Who cites it
2 citing papers in PubMed.
- Community pharmacy transformation under universal health coverage: Implementation barriers, cultural determinants, and cross-national lessons from Japan's ongoing transition - A narrative review.Exploratory research in clinical and social pharmacy · 2026Review
- Global patterns and trends in spontaneous reporting systems: VigiBase, FAERS, VAERS, and JADER.Frontiers in drug safety and regulation · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGlobal aging makes polypharmacy in older adults a critical concern. Pharmacist-led deprescribing shows promise, but lacks routine implementation. Japan introduced "the Medication Adjustment Support Fee (the Adjustment Fee)" in 2018 for deprescribing medications in patients with polypharmacy based on pharmacists' recommendations.
objectiveWe aimed to investigate: (1) medication distribution among older patients; (2) medications most frequently deprescribed based on pharmacists' recommendations; and (3) factors associated with successful deprescribing.
methodsThis retrospective study analysed patients aged ≥ 65 years who had prescriptions dispensed for ≥ 60 days from 2069 community pharmacies (April 2020-September 2023). Eligibility for the adjustment fee required six or more oral medications for ≥ 4 weeks, with pharmacists receiving remuneration when two or more medications were deprescribed and sustained for ≥ 4 weeks. We examined: (1) medication distribution in older patients; (2) most frequently deprescribed medications based on pharmacists' recommendations; and (3) factors associated with deprescribing using multi-level logistic regression.
resultsAmongst 1,458,323 older patients, 36.9% (537,884) met the eligibility criteria for the adjustment fee, but only 0.08% had medications deprescribed based on pharmacist recommendations. At the pharmacy level, 10% of pharmacies (213/2069) claimed the fee at least once. The most frequently deprescribed medications were rebamipide (0.05%), mecobalamin (0.06%) and magnesium oxide (0.02%). Older age, higher number of medications taken, presence of a family pharmacist, and longer evaluation periods were significantly associated with claiming for the adjustment fee (p < 0.001 for all).
conclusionsPharmacist-led deprescribing is infrequently implemented. Future studies could investigate the potential of strengthened incentives, enhanced collaboration, and robust protocols to optimize medication management in older adults.
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Registered trials
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