Outcomes of pharmacist‐led deprescribing interventions in older adults living in long‐term care facilities: a scoping review
Sefunmi Odetola, Eileen Willis, Katrina Lane‐Krebs, Ashlyn SahayAbstract
Background
An increase in the ageing population across long‐term care facilities (LTCFs) has led to an increased risk of polypharmacy. Pharmacist‐led deprescribing (PLD) can reduce these risks but there are limitations to its widespread uptake.
Aim
To explore PLD interventions for residents in RACFs, focusing on outcomes measured and research gaps.
Design
A scoping review was conducted following the Arksey and O'Malley 2005 framework and reported in line with the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) guidelines. CINAHL, Embase, PubMed, and Scopus were searched for peer reviewed articles on deprescribing interventions in older adults in LTCFs that were published online and in the English language from 2017–May 2024.
Results
Nine studies were included. Across the included studies, reductions in inappropriate medication use were commonly reported following PLD interventions, while the effects on patient‐related outcomes varied. Some studies showed reductions in drug burden index scores and falls, specifically those targeting sedative or anti‐cholinergic medications. Adverse events were inconsistently assessed, and effects on cognitive function and quality of life (QoL) were mixed. Two studies reported on economic outcomes, indicating cost savings associated with deprescribing. Significant variation was observed in outcome measures used to assess deprescribing across studies.
Conclusion
PLD interventions in residential aged care have been evaluated using a wide range of medication‐related, clinical, patient‐related, implementation, and economic outcomes across different settings. Limited long‐term evidence exists for cognitive and QoL outcomes. A significant gap in findings is the variability in the outcomes reported in deprescribing intervention studies. Standardised outcome measures are needed to support more rigorous evaluation and comparison of PLD interventions.