Polypharmacy is common in older adults and is associated with adverse
drug events, cognitive and functional impairment, increased healthcare
costs, and increased risk of frailty, falls, hospitalizations, and
mortality. Many barriers exist to deprescribing, but increased efforts have
been made to develop and implement deprescribing interventions that overcome
them. This narrative review describes intervention components and summarizes
findings from published randomized controlled trials that have tested
deprescribing interventions in older adults with polypharmacy, as well as
reports on ongoing trials, guidelines, and resources that can be used to
facilitate deprescribing. Most interventions were medication reviews in
primary care settings, and many contained components such as shared decision
making and/or a focus on patient care priorities, training for healthcare
professionals, patient facing education materials, and involvement of family
members, representing great heterogeneity in interventions addressing
polypharmacy in older adults. Just over half of study interventions were
found to perform better than usual care in at least one of their primary
outcomes, and most study interventions were assessed over 12 months or
less.