Evidence map›Paper›PMID 31483057›Full record

SynthesisBritish journal of clinical pharmacology2020

Outcomes of deprescribing interventions in older patients with life-limiting illness and limited life expectancy: A systematic review.

Shakti Shrestha, Arjun Poudel, Kathryn Steadman, Lisa Nissen

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of clinical pharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 4 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  14. Pharmacist-led deprescribing interventions for cancer patients in a specialist palliative care setting.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Shakti ShresthaSchool of Pharmacy, University of Queensland, Brisbane, QLD, Australia.ORCID 0000-0003-0344-091X
Arjun PoudelSchool of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia.ORCID 0000-0003-3601-4650
Kathryn SteadmanSchool of Pharmacy, University of Queensland, Brisbane, QLD, Australia.ORCID 0000-0001-7357-330X
Lisa NissenSchool of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia.ORCID 0000-0001-5826-4605

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsOlder patients with life-limiting illness (LLI) and limited life expectancy (LLE) continue to receive potentially inappropriate medicines, consequently deprescribing is often necessary. However, deprescribing in this population can be complex and challenging. Therefore, we aimed to investigate the evidence for outcomes of deprescribing interventions in older patients with LLI and LLE.

methodsStudies on deprescribing intervention and their outcomes in age ≥65 years with LLI and LLE were searched using PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and Google Scholar. Medication appropriateness was primary outcome, while clinical and cost-related outcomes were secondary. Eligibility, data extraction and quality assessment were followed by a narrative synthesis of data.

resultsOf 9 studies (1375 participants), 3 reported on primary outcome. One study showed a significant reduction in medication inappropriateness by 34.9% (P < .001) from admission to close-out, the second achieved 29.4% (P < .001) and 15.1% (P = .003) reduction at 12 and 24 months, respectively. The third reported that their intervention stopped (17.2%) and altered the dose (2.6%) of high-risk medications. Commonly reported clinical outcomes were mortality (n = 3), quality of life (n = 2) and falls (n = 2). Outcomes in terms of cost were reported as overall cost (n = 2), medication cost (n = 1) and health care expenditure (n = 1).

conclusionOur findings suggest that deprescribing in older patients with LLI and LLE can improve medication appropriateness, and has potential for enhancement of several clinical outcomes and cost savings, but the evidence needs to be better established.

Indexed as

DeprescriptionsAgedHospitalizationHumansLife ExpectancyQuality of Lifedeprescribingend-of-lifeolder adultsoutcomessystematic reviewterminally ill

Identifiers

PMID31483057
PMCPMC7495295

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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 Socratic graph.