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Expert Opinion on Drug Safety Volume 17, 2018 - Issue 1
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Review

A narrative review of the safety concerns of deprescribing in older adults and strategies to mitigate potential harms

Emily ReeveCognitive Decline Partnership Centre, Ageing and Pharmacology, Kolling Institute of Medical Research, School of Medicine, University of Sydney, St Leonards, NSW, Australia;Geriatric Medicine Research, Dalhousie University Faculty of Medicine, Halifax, NS, Canada;Faculty of Health Professions - College of Pharmacy, Dalhousie University, Halifax, NS, CanadaCorrespondence[email protected]
ORCID Iconhttp://orcid.org/0000-0002-1405-999XView further author information
ORCID Icon,
Frank MoriartyHRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, IrelandORCID Iconhttp://orcid.org/0000-0001-9838-3625View further author information
ORCID Icon,
Rayan NahasDepartments of Aged Care and Clinical Pharmacology, Royal North Shore Hospital, Saint Leonards, NSW, AustraliaView further author information
,
Justin P. TurnerCentre de recherché, Universite de Montreal Institut universitaire de geriatrie de Montreal, Montreal, QC, Canada;Faculte de pharmacie, Universite de Montreal, Montreal, QC, CanadaView further author information
,
Lisa Kouladjian O’DonnellCognitive Decline Partnership Centre, Ageing and Pharmacology, Kolling Institute of Medical Research, School of Medicine, University of Sydney, St Leonards, NSW, Australia;Departments of Aged Care and Clinical Pharmacology, Royal North Shore Hospital, Saint Leonards, NSW, AustraliaView further author information
&
Sarah N. HilmerCognitive Decline Partnership Centre, Ageing and Pharmacology, Kolling Institute of Medical Research, School of Medicine, University of Sydney, St Leonards, NSW, Australia;Departments of Aged Care and Clinical Pharmacology, Royal North Shore Hospital, Saint Leonards, NSW, AustraliaORCID Iconhttp://orcid.org/0000-0002-5970-1501View further author information
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Pages 39-49 | Received 02 Aug 2017, Accepted 24 Oct 2017, Published online: 06 Nov 2017

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Harry Wu, Lisa Kouladjian O’Donnell, Kenji Fujita, Nashwa Masnoon & Sarah N Hilmer. (2021) Deprescribing in the Older Patient: A Narrative Review of Challenges and Solutions. International Journal of General Medicine 14, pages 3793-3807.
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Sayeeda Rahman, Keerti Singh, Sameer Dhingra, Jaykaran Charan, Paras Sharma, Salequl Islam, Dilshad Jahan, Katia Iskandar, Nandeeta Samad & Mainul Haque. (2020) The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population – Public Health Implications. Therapeutics and Clinical Risk Management 16, pages 1007-1022.
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Gregorio Sanz-Tamargo, Sergio García-Cases, Andrés Navarro & Blanca Lumbreras. (2019) Adaptation of a deprescription intervention to the medication management of older people living in long-term care facilities. Expert Opinion on Drug Safety 18:11, pages 1091-1098.
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Jamie J. Coleman. (2019) Prescribing in 2019: what are the safety concerns?. Expert Opinion on Drug Safety 18:2, pages 69-74.
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Articles from other publishers (36)

Cynthia M. Boyd, Susan M. Shetterly, John D. Powers, Linda A. Weffald, Ariel R. Green, Orla C. Sheehan, Emily Reeve, Melanie L. Drace, Jonathan D. Norton, Mahesh Maiyani, Kathy S. Gleason, Jennifer K. Sawyer, Matthew L. Maciejewski, Jennifer L. Wolff, Courtney Kraus & Elizabeth A. Bayliss. (2023) Evaluating the Safety of an Educational Deprescribing Intervention: Lessons from the Optimize Trial. Drugs & Aging.
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Anne Estrup Olesen, Tanja Joest Væver, Martin Simonsen, Peter Gaardbo Simonsen & Kirsten Høj. (2023) Deprescribing in primary care without deterioration of health‐related outcomes: A real‐life, quality improvement project. Basic & Clinical Pharmacology & Toxicology.
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Gabbie E. Portlock, Matthew D. Smith, Eveline P. van Poelgeest & Tomas James Welsh. (2023) Therapeutic dilemmas: cognitive enhancers and risk of falling in older adults—a clinical review. European Geriatric Medicine.
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Benjamin H. Balderson, Shelly L. Gray, Monica M. Fujii, Kanichi G. Nakata, Brian D. Williamson, Andrea J. Cook, Robert Wellman, Mary Kay Theis, Cara C. Lewis, Dustin Key & Elizabeth A. Phelan. (2023) A health-system-embedded deprescribing intervention targeting patients and providers to prevent falls in older adults (STOP-FALLS trial): study protocol for a pragmatic cluster-randomized controlled trial. Trials 24:1.
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Christopher Etherton-Beer, Amy Page, Vasi Naganathan, Kathleen Potter, Tracy Comans, Sarah N Hilmer, Andrew J McLachlan, Richard I Lindley & Dee Mangin. (2023) Deprescribing to optimise health outcomes for frail older people: a double-blind placebo-controlled randomised controlled trial—outcomes of the Opti-med study. Age and Ageing 52:5.
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Jonatan Kornholt, Cille Bülow, Anne Mette S. Sørensen, Eckart Pressel, Tonny S. Petersen & Mikkel B. Christensen. (2022) Scoping Review of Randomized Trials With Discontinuation of Medicines in Older Adults. Journal of the American Medical Directors Association 23:12, pages 1926.e11-1926.e35.
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Reham A. Kalim, Conal J. Cunningham, Sheila A. Ryder & Niamh M. McMahon. (2022) Deprescribing Medications that Increase the Risk of Falls in Older People: Exploring Doctors' Perspectives Using the Theoretical Domains Framework (TDF). Drugs & Aging 39:12, pages 935-947.
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Lisa Kouladjian O’Donnell & Kinda Ibrahim. (2022) Polypharmacy and deprescribing: challenging the old and embracing the new. BMC Geriatrics 22:1.
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Elizabeth A. Bayliss, Kathleen Albers, Kathy Gleason, Lisa E. Pieper, Cynthia M. Boyd, Noll L. Campbell, Kristine E. Ensrud, Shelly L. Gray, Amy M. Linsky, Derelie Mangin, Lillian Min, Michael W. Rich, Michael A. Steinman, Justin Turner, Eduard E. Vasilevskis & Sascha Dublin. (2022) Recommendations for outcome measurement for deprescribing intervention studies. Journal of the American Geriatrics Society 70:9, pages 2487-2497.
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Joseph T. Hanlon & Shelly L. Gray. (2022) Deprescribing trials: A focus on adverse drug withdrawal events. Journal of the American Geriatrics Society 70:9, pages 2738-2741.
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Elizabeth A. Bayliss, Susan M. Shetterly, Melanie L. Drace, Jonathan D. Norton, Mahesh Maiyani, Kathy S. Gleason, Jennifer K. Sawyer, Linda A. Weffald, Ariel R. Green, Emily Reeve, Matthew L. Maciejewski, Orla C. Sheehan, Jennifer L Wolff, Courtney Kraus & Cynthia M. Boyd. (2022) Deprescribing Education vs Usual Care for Patients With Cognitive Impairment and Primary Care Clinicians. JAMA Internal Medicine 182:5, pages 534.
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Makayla W. NelsonTara N. DownsGina M. PuglisiBrent A. SimpkinsAmy Schmelzer Collier. (2022) Use of a Deprescribing Tool in an Interdisciplinary Primary-Care Patient-Aligned Care Team. The Senior Care Pharmacist 37:1, pages 34-43.
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Heather Davila, Amy K. Rosen, Kelly Stolzmann, Libin Zhang & Amy M. Linsky. (2021) Factors influencing providers' willingness to deprescribe medications. JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 5:1, pages 15-25.
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John Mach, Gizem Gemikonakli, Caitlin Logan, Brent Vander Wyk, Heather Allore, Swathi Ekambareshwar, Alice E Kane, Susan E Howlett, Rafael de Cabo, David G Le Couteur & Sarah N Hilmer. (2021) Chronic Polypharmacy with Increasing Drug Burden Index Exacerbates Frailty and Impairs Physical Function, with Effects Attenuated by Deprescribing, in Aged Mice. The Journals of Gerontology: Series A 76:6, pages 1010-1018.
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Joseph T. HanlonJennifer Tjia. (2021) Avoiding Adverse Drug Withdrawal Events When Stopping Unnecessary Medications According to the STOPPFrail Criteria. The Senior Care Pharmacist 36:3, pages 136-141.
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Justin Lee, Ahmed Negm, Ryan Peters, Eric K C Wong & Anne Holbrook. (2021) Deprescribing fall-risk increasing drugs (FRIDs) for the prevention of falls and fall-related complications: a systematic review and meta-analysis. BMJ Open 11:2, pages e035978.
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Maria Teresa Chiarelli, Stefania Antoniazzi, Laura Cortesi, Luca Pasina, Alessio Novella, Francesca Venturini, Alessandro Nobili & Pier Mannuccio Mannucci. (2021) Pharmacist-driven medication recognition/ reconciliation in older medical patients. European Journal of Internal Medicine 83, pages 39-44.
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Sabrina Lau, Penny Lun, Wendy Ang, Keng Teng Tan & Yew Yoong Ding. (2020) Barriers to effective prescribing in older adults: applying the theoretical domains framework in the ambulatory setting – a scoping review. BMC Geriatrics 20:1.
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Raechel A. Damarell, Deidre D. Morgan & Jennifer J. Tieman. (2020) General practitioner strategies for managing patients with multimorbidity: a systematic review and thematic synthesis of qualitative research. BMC Family Practice 21:1.
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Anne O’ Keeffe, Sile O’ Grady, Finola Cronin, Clodagh Dolan, Ann O’ Hea, Katie Louise O’ Shea & Corina Naughton. (2020) Evaluation of an emergency department falls pathway for older people: A patient chart review. International Emergency Nursing 51, pages 100869.
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Barbara D’Avanzo, Pasquale Agosti, Emily Reeve, Luca Pasina, Carlo Sabbà, Pier Mannuccio Mannucci & Alessandro Nobili. (2020) Views of medical practitioners about deprescribing in older adults: Findings from an Italian qualitative study. Maturitas 134, pages 29-33.
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Mouna Sawan, Lisa Kouladjian O’Donnell & Sarah N. Hilmer. (2019) Perspectives of residential aged care facilities' staff on the identification and recording of residents' medication‐related goals of care. Australasian Journal on Ageing 39:1.
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Katherine Le Bosquet, Nina Barnett & John Minshull. (2019) Deprescribing: Practical Ways to Support Person-Centred, Evidence-Based Deprescribing. Pharmacy 7:3, pages 129.
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Ana Alves, Shaun Green & Delyth H James. (2019) Deprescribing of Medicines in Care Homes—A Five-Year Evaluation of Primary Care Pharmacist Practices. Pharmacy 7:3, pages 105.
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Matthew J. Stinson, Samuel Gurevitz & Anna Carrigan. (2019) Deprescribing at the end of life in older patients. JAAPA 32:7, pages 20-24.
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Alexander J. Clough, Sarah N. Hilmer, Lisa Kouladjian‐O'Donnell, Sharon L. Naismith & Danijela Gnjidic. (2019) Health professionals’ and researchers’ opinions on conducting clinical deprescribing trials. Pharmacology Research & Perspectives 7:3, pages e00476.
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Mary E. Walsh, Fiona Boland, Frank Moriarty & Tom Fahey. (2019) Modification of Potentially Inappropriate Prescribing Following Fall-Related Hospitalizations in Older Adults. Drugs & Aging 36:5, pages 461-470.
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Angela Nachtigall, Hans J. Heppner & Petra A. Thürmann. (2019) Influence of pharmacist intervention on drug safety of geriatric inpatients: a prospective, controlled trial. Therapeutic Advances in Drug Safety 10, pages 204209861984336.
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Wade Thompson, Carina Lundby, Trine Graabaek, Dorthe S. Nielsen, Jesper Ryg, Jens Søndergaard & Anton Pottegård. (2019) Tools for Deprescribing in Frail Older Persons and Those with Limited Life Expectancy: A Systematic Review. Journal of the American Geriatrics Society 67:1, pages 172-180.
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Ana Hategan, James A. Bourgeois, Tracy Cheng & Julie YoungAna Hategan, James A. Bourgeois, Tracy Cheng & Julie Young. 2018. Geriatric Psychiatry Study Guide. Geriatric Psychiatry Study Guide 131 162 .

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