A critical evaluation of available explicit deprescribing tools for their applicability to Indian elderly patients: a scoping review protocol.

Background: Among the elderly, who are often exposed to polypharmacy, explicit deprescribing tools offer clear, validated guidelines for safely reducing medications. However, the effectiveness of these tools varies across healthcare settings and populations. In India, unique sociocultural and healthcare challenges demand a tailored approach to deprescribing for elderly patients, and the need to adapt existing tools to local contexts. The primary objective of this scoping review is mapping of the contextual relevance and applicability of the existing explicit deprescribing tools for elderly population in Indian healthcare settings.

Methodology: The scoping review will be carried out in six stages: (1) Identifying the review question. (2) Identifying relevant studies through electronic databases (i.e., PubMed, Web of Science, and Embase). (3) Selection of studies to be included based on inclusion and exclusion criteria. Inclusion criteria for this scoping review are studies implementing explicit deprescribing tools involving Indian elderly patients, reporting on outcomes, validation methods, or contextual relevance of deprescribing tools, published in English or non-English language with English translation available. Exclusion criteria for this scoping review are studies focused on implicit deprescribing tools, review articles, case reports, commentaries, and editorials. Two independent reviewers will conduct the search and initial screening of studies. Discrepancies will then be solved through discussion with the third reviewer. (4) Charting, categorizing, and thematic analysis of the extracted data. (5) Collating, summarizing, and reporting the results. (6) Dissemination of findings.

Discussion: By reviewing the patient population and study setting of studies of explicit tools in India, vis a vis the healthcare setting and patient population for which the tool was designed, our scoping review highlighted the strengths and weaknesses in the existing literature. These findings could be used to direct future research and assess the need for a deprescribing tool adapted for the Indian elderly patients.