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Impact of Deprescribing Among Older Adults in Primary Care Settings: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Christina Malini Christopher Orcid Logo, Bhuvan KC, Mark Wing Loong Cheong Orcid Logo, Rajeev Shrestha Orcid Logo, Sunil Shrestha Orcid Logo, Juman Al-Dujaili Orcid Logo, Ali Blebil Orcid Logo

Aging Medicine

Swansea University Authors: Juman Al-Dujaili Orcid Logo, Ali Blebil Orcid Logo

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DOI (Published version): 10.1002/agm2.70075

Abstract

Background: Deprescribing is a systematic approach aimed at reducing the number of medications that are no longer beneficial or appropriate. This study aims to assess the various types of deprescribing and the outcomes among older adults in primary health care. The electronic search for original art...

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Published in: Aging Medicine
ISSN: 2475-0360 2475-0360
Published: Wiley 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa71738
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This study aims to assess the various types of deprescribing and the outcomes among older adults in primary health care. The electronic search for original articles was conducted using the following electronic databases: MEDLINE, EMBASE, Scopus, PsycINFO, and Global Health. The types of deprescribing interventions and their outcomes in older adults were assessed and compared with those of non-intervention. The risk of bias was assessed using the Robins tool. Eighteen randomized controlled trials were included after full-text screening. These studies evaluated a range of deprescribing interventions implemented in primary healthcare settings. The interventions included medication reviews, academic detailing, pharmacist-led deprescribing, computerized decision-support tools, structured education, patient-centered communication, and coordinated medication risk management. 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spelling 2026-04-30T14:22:02.5899815 v2 71738 2026-04-14 Impact of Deprescribing Among Older Adults in Primary Care Settings: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials 47d192c8bb46dd4c0cc72bbfea4210ec 0000-0002-7515-5344 Juman Al-Dujaili Juman Al-Dujaili true false ae3f126adda1dec7b84f0a12698f0b7d 0000-0002-7480-1260 Ali Blebil Ali Blebil true false 2026-04-14 MEDS Background: Deprescribing is a systematic approach aimed at reducing the number of medications that are no longer beneficial or appropriate. This study aims to assess the various types of deprescribing and the outcomes among older adults in primary health care. The electronic search for original articles was conducted using the following electronic databases: MEDLINE, EMBASE, Scopus, PsycINFO, and Global Health. The types of deprescribing interventions and their outcomes in older adults were assessed and compared with those of non-intervention. The risk of bias was assessed using the Robins tool. Eighteen randomized controlled trials were included after full-text screening. These studies evaluated a range of deprescribing interventions implemented in primary healthcare settings. The interventions included medication reviews, academic detailing, pharmacist-led deprescribing, computerized decision-support tools, structured education, patient-centered communication, and coordinated medication risk management. Quantitative analysis revealed that two studies reported a statistically significant reduction in patient falls due to deprescribing (OR: 0.67; 95% CI: [0.46, 0.98]; I2 = 0%; p = 0.04). Sensitivity analysis further demonstrated that deprescribing significantly reduced the average number of medications used by older adults (MD: 0.17; 95% CI: [0.03, 0.32]; p = 0.02) and was associated with a significant decrease in hospitalisations in this population (RR: 1.40; 95% CI: [1.08, 1.80]; p = 0.01). Deprescribing interventions in primary care have been proven to result in a modest reduction in the number of medications prescribed to older adults and could help reduce falls, with potential benefits for reducing hospitalization. Trial Registration: Prospero CRD42023464445 Journal Article Aging Medicine 0 Wiley 2475-0360 2475-0360 deprescribing, medication review, older adults, outcomes, systematic review 26 4 2026 2026-04-26 10.1002/agm2.70075 Review Article COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University SU Library paid the OA fee (TA Institutional Deal) Swansea University 2026-04-30T14:22:02.5899815 2026-04-14T10:19:33.9190319 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Pharmacy Christina Malini Christopher 0000-0002-0272-2117 1 Bhuvan KC 2 Mark Wing Loong Cheong 0000-0002-8652-7369 3 Rajeev Shrestha 0000-0003-1822-3969 4 Sunil Shrestha 0000-0002-9174-7120 5 Juman Al-Dujaili 0000-0002-7515-5344 6 Ali Blebil 0000-0002-7480-1260 7 71738__36645__727de4cafc1c4f1f858d382a2ab384df.pdf 71738.VOR.pdf 2026-04-30T14:16:30.7627287 Output 1168399 application/pdf Version of Record true © 2026 The Author(s). Aging Medicine published by Beijing Hospital and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the Creative Commons Attribution License. true eng http://creativecommons.org/licenses/by/4.0/
title Impact of Deprescribing Among Older Adults in Primary Care Settings: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
spellingShingle Impact of Deprescribing Among Older Adults in Primary Care Settings: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Juman Al-Dujaili
Ali Blebil
title_short Impact of Deprescribing Among Older Adults in Primary Care Settings: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
title_full Impact of Deprescribing Among Older Adults in Primary Care Settings: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
title_fullStr Impact of Deprescribing Among Older Adults in Primary Care Settings: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
title_full_unstemmed Impact of Deprescribing Among Older Adults in Primary Care Settings: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
title_sort Impact of Deprescribing Among Older Adults in Primary Care Settings: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
author_id_str_mv 47d192c8bb46dd4c0cc72bbfea4210ec
ae3f126adda1dec7b84f0a12698f0b7d
author_id_fullname_str_mv 47d192c8bb46dd4c0cc72bbfea4210ec_***_Juman Al-Dujaili
ae3f126adda1dec7b84f0a12698f0b7d_***_Ali Blebil
author Juman Al-Dujaili
Ali Blebil
author2 Christina Malini Christopher
Bhuvan KC
Mark Wing Loong Cheong
Rajeev Shrestha
Sunil Shrestha
Juman Al-Dujaili
Ali Blebil
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publishDate 2026
institution Swansea University
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doi_str_mv 10.1002/agm2.70075
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_title Faculty of Medicine, Health and Life Sciences
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hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Pharmacy{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Pharmacy
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description Background: Deprescribing is a systematic approach aimed at reducing the number of medications that are no longer beneficial or appropriate. This study aims to assess the various types of deprescribing and the outcomes among older adults in primary health care. The electronic search for original articles was conducted using the following electronic databases: MEDLINE, EMBASE, Scopus, PsycINFO, and Global Health. The types of deprescribing interventions and their outcomes in older adults were assessed and compared with those of non-intervention. The risk of bias was assessed using the Robins tool. Eighteen randomized controlled trials were included after full-text screening. These studies evaluated a range of deprescribing interventions implemented in primary healthcare settings. The interventions included medication reviews, academic detailing, pharmacist-led deprescribing, computerized decision-support tools, structured education, patient-centered communication, and coordinated medication risk management. Quantitative analysis revealed that two studies reported a statistically significant reduction in patient falls due to deprescribing (OR: 0.67; 95% CI: [0.46, 0.98]; I2 = 0%; p = 0.04). Sensitivity analysis further demonstrated that deprescribing significantly reduced the average number of medications used by older adults (MD: 0.17; 95% CI: [0.03, 0.32]; p = 0.02) and was associated with a significant decrease in hospitalisations in this population (RR: 1.40; 95% CI: [1.08, 1.80]; p = 0.01). Deprescribing interventions in primary care have been proven to result in a modest reduction in the number of medications prescribed to older adults and could help reduce falls, with potential benefits for reducing hospitalization. Trial Registration: Prospero CRD42023464445
published_date 2026-04-26T07:03:24Z
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