Deprescribing in Australian residential aged care facilities: A scoping review

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing Pub Date : 2025-02-22 DOI:10.1111/ajag.13415

Jenny Xinyu Liang, Louise Thai, Madeleine Healy, Adam Mohd Idris, Jian Wey Chin, Christopher Grossman

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引用次数: 0

Abstract

Objectives

Older adults residing in residential aged care facilities (RACFs) are particularly vulnerable to negative health outcomes from polypharmacy and suboptimal prescribing in the context of frailty and multimorbidity. Deprescribing, the intentional withdrawal of inappropriate medications, has been proposed as a promising approach to reduce polypharmacy-related harms. Examining current deprescribing interventions in RACFs would help identify gaps in research knowledge. The aim of this scoping review was to synthesise the current literature, describe the current knowledge gaps and future research priorities that the authors identified.

Methods

MEDLINE, Embase, CINAHL, PsycINFO and AgeLine were searched according to the Joanna Briggs Institute (JBI) guidelines for scoping reviews from inception until February 2024 to identify relevant studies published in the English language.

Results

Of the 2244 articles screened, 13 studies (total of 133,150 RACF residents across Australia) were identified examining deprescribing interventions. Six studies were controlled trials and seven studies were observational studies. There were six pharmacist-led interventions, five multidisciplinary team-led interventions and two physician-led interventions. Main themes discussed included as follows: multidisciplinary care, education for health-care professionals, refining outcome measures, overcoming system issues and research logistics. The most commonly targeted medications in the included studies were psychotropics.

Conclusions

Deprescribing is an important intervention for RACF residents but more research into translating evidence into clinically meaningful outcomes is needed. Successful studies typically involved multidisciplinary interventions, had an educational component, followed-up longitudinally with residents and carers and involved stakeholders, such as nurses. The economic impacts of deprescribing in this cohort are poorly understood.

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澳大利亚养老院中的去处方化：范围界定审查

居住在老年护理机构（racf）的老年人在身体虚弱和多重疾病的情况下，特别容易受到多种药物和次优处方的负面健康结果的影响。开处方，即有意停用不适当的药物，已被认为是减少多药相关危害的一种有希望的方法。检查racf中目前的处方干预措施将有助于确定研究知识方面的差距。本次范围综述的目的是综合当前文献，描述当前的知识差距和作者确定的未来研究重点。方法根据乔安娜布里格斯研究所（Joanna Briggs Institute， JBI）自成立至2024年2月的文献综述指南，对MEDLINE、Embase、CINAHL、PsycINFO和AgeLine进行检索，确定已发表的相关英文文献。结果在筛选的2244篇文章中，有13项研究（澳大利亚共有133,150名RACF居民）被确定为检查处方干预措施。6项研究为对照试验，7项研究为观察性研究。有6个药剂师主导的干预，5个多学科团队主导的干预和2个医生主导的干预。讨论的主题包括：多学科护理、卫生保健专业人员的教育、改进结果测量、克服系统问题和研究后勤。在纳入的研究中，最常见的靶向药物是精神类药物。结论开处方是RACF居民的重要干预措施，但需要更多的研究将证据转化为有临床意义的结果。成功的研究通常涉及多学科干预，具有教育成分，对居民和护理人员以及相关利益相关者（如护士）进行纵向随访。在这个队列中，人们对处方的经济影响知之甚少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australasian Journal on Ageing 医学-老年医学

CiteScore

3.10

自引率

6.20%

发文量

114

审稿时长

>12 weeks

期刊介绍： Australasian Journal on Ageing is a peer reviewed journal, which publishes original work in any area of gerontology and geriatric medicine. It welcomes international submissions, particularly from authors in the Asia Pacific region.