A recent systematic review and meta-analysis has highlighted the impact of medication review and deprescribing interventions on polypharmacy among older adults residing in long-term care facilities (LTCFs). The study, which adhered to PRISMA guidelines and analyzed data from 38 studies (22 randomized controlled trials and 16 quasi-experimental studies), found that these interventions significantly reduced the number of medications per patient and the prevalence of potentially inappropriate medications (PIMs).

The findings indicate a pooled reduction of 0.89 medications per patient within 12 months and 1.60 medications at 12 months or longer, alongside a decrease in PIMs by 0.48 at 6 months and 0.26 at 12 months. However, the review did not observe significant changes in critical clinical outcomes such as falls, hospitalizations, or mortality rates. The authors noted considerable methodological heterogeneity and a moderate to high risk of bias across the included studies, underscoring the need for more rigorous research in this area.

The takeaway from this analysis is the clear therapeutic potential of structured medication review processes in enhancing prescribing appropriateness for older adults with polypharmacy, despite the lack of direct impact on clinical outcomes. This underscores a shift in focus towards optimizing medication regimens in LTCFs, which may inform future drug development and clinical practice guidelines. The call for high-quality studies with standardized methodologies is crucial for establishing robust evidence that could ultimately improve healthspan and reduce adverse drug events in this vulnerable population.

Source: academic.oup.com