• Wade Thompson, Carina Lundby, Trine Graabaek, Dorthe S Nielsen, Jesper Ryg, Jens Søndergaard, and Anton Pottegård.
• Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
• J Am Geriatr Soc. 2019 Jan 1; 67 (1): 172-180.

ObjectivesTo summarize available tools that can assist clinicians in identifying and reducing or stopping (deprescribing) potentially inappropriate medications and that specifically consider frailty or limited life expectancy.DesignSystematic review and narrative synthesis.SettingWe searched MEDLINE (via Ovid SP), EMBASE (via Ovid SP), and CINAHL from inception to December 2017, along with grey literature. We included articles that described a tool to guide deprescribing of medications.ParticipantsFrail older persons and older persons with limited life expectancy.MeasurementsNarrative description of tools.ResultsWe identified 15 tools and organized them into three main categories: tools (n = 2) that described a model or framework for approaching deprescribing, tools (n = 9) that outlined a deprescribing approach for the entire medication list, and tools (n = 4) that provided medication-specific advice. The complexity of the tools ranged from simple lists to detailed, step-wise protocols. The development methodology varied widely, and the methods used to synthesize the tools were generally not well described. Most tools were based on expert opinion. Only four of the 15 tools have been tested in clinical practice (in very low-quality studies).ConclusionTools exist to help clinicians deprescribe in frail older persons and those with limited life expectancy. These tools may assist clinicians at various stages in the deprescribing process. However, it remains to be investigated whether use of such tools in practice is likely to improve clinical outcomes or reduce inappropriate medication use. J Am Geriatr Soc 67:172-180, 2019.© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

17 keywords...

hide…