Assessing the Feasibility of Deprescribing Strategies in Comprehensive Medication Reviews: A Process Evaluation

Abstract

To optimize medication in older patients with polypharmacy, medication reviews (CMRs) are periodically conducted by community pharmacists (CPs), applying the Multidisciplinary Guideline Polypharmacy in Older Patients (MDRP) in primary care. CP-led interventions contribute to improved adherence and better disease control, with conducting CMRs being part of daily practice usual care of CPs . In recent years, deprescribing has been introduced to withdraw inappropriate medication supervised by a healthcare provider to manage polypharmacy and improve outcomes. Deprescribing may improve quality of life and decrease the risk of adverse drug events and is indicated when a medication may lead to more harm than benefits. Deprescribing of cardiometabolic medication, such as glucose-lowering and antihypertensive medication, in patients with multiple comorbidities, frailty, hypoglycemic risk, or a limited life expectancy seems feasible and safe. However, implementing deprescribing in daily practice has been challenging due to CPs' lack of knowledge and insecurity concerning the process and the efficacy of preventive medications in older adults.