Evaluation of real-world evidence to assess health outcomes related to deprescribing medications in older adults: an International Society for Pharmacoepidemiology–endorsed systematic review of methodology

Observational studies using real-world data (RWD) can address gaps in knowledge on deprescribing medications but are subject to methodological issues. Limited data exist on the methods employed to use RWD to measure the effects of deprescribing. To describe methodological approaches used in observational studies of deprescribing medications in older adults, we conducted a systematic review in Medline for observational studies published in English (January 1, 2000, to September 14, 2023) that examined the health effects of medication deprescribing in older adults. We described study characteristics and methods, focusing on the operationalization of deprescribing as an exposure and potential time-related biases. Forty-five studies were included, representing a variety of drug classes (eg, statins, aspirin, bisphosphonates) and diseases. Most studies adequately addressed potential time-related biases. The definition of deprescribing was not clearly defined in 12 studies. There was heterogeneity regarding the minimum duration of time that qualified as deprescribing, even within a drug class; fewer than one-third of studies provided a justification for these definitions. Observational studies are common to examine the effects of deprescribing; however, there were inconsistencies in measuring deprescribing and a lack of transparency in reporting. There is a need for minimum sufficient reporting criteria for observational studies on deprescribing.

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Publication Details

Journal
American Journal of Epidemiology
Published
2024-11-04
DOI
https://doi.org/10.1093/aje/kwae425
Citations
6
Primary Topic
Pharmaceutical Practices and Patient Outcomes
Type
article
Field-Weighted Citation Impact
2.07

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article

Evaluation of real-world evidence to assess health outcomes related to deprescribing medications in older adults: an International Society for Pharmacoepidemiology–endorsed systematic review of methodology

Danijela Gnjidic, Joshua D. Niznik, Marie‐Laure Laroche, Xiojuan Li et al.
6 citations
American Journal of Epidemiology
Pharmaceutical Practices and Patient Outcomes
2.07
article

Evaluation of real-world evidence to assess health outcomes related to deprescribing medications in older adults: an International Society for Pharmacoepidemiology–endorsed systematic review of methodology

Danijela Gnjidic, Joshua D. Niznik, Marie‐Laure Laroche, Xiojuan Li, Caroline Sirois, Sirui Zhang, Mouna Sawan, Shahar Shmuel, Denis Talbot, Maurizio Sessa, Andrew R. Zullo, Jennifer L. Lund, Miia Tiihonen, Antoinette B. Coe, Kaleen N. Hayes, Dimitri Bennett, Matthew Alcusky, Daniela C. Moga, Frank Moriarty, Jin Lin, Sirpa A. Hartikainen, Xuerong Wen, Nguyen K. Tran
article en
6 citations

Abstract

Observational studies using real-world data (RWD) can address gaps in knowledge on deprescribing medications but are subject to methodological issues. Limited data exist on the methods employed to use RWD to measure the effects of deprescribing. To describe methodological approaches used in observational studies of deprescribing medications in older adults, we conducted a systematic review in Medline for observational studies published in English (January 1, 2000, to September 14, 2023) that examined the health effects of medication deprescribing in older adults. We described study characteristics and methods, focusing on the operationalization of deprescribing as an exposure and potential time-related biases. Forty-five studies were included, representing a variety of drug classes (eg, statins, aspirin, bisphosphonates) and diseases. Most studies adequately addressed potential time-related biases. The definition of deprescribing was not clearly defined in 12 studies. There was heterogeneity regarding the minimum duration of time that qualified as deprescribing, even within a drug class; fewer than one-third of studies provided a justification for these definitions. Observational studies are common to examine the effects of deprescribing; however, there were inconsistencies in measuring deprescribing and a lack of transparency in reporting. There is a need for minimum sufficient reporting criteria for observational studies on deprescribing.

American Journal of EpidemiologyVol. 194(8)
University of North Carolina at Chapel Hill (US), University of Copenhagen (DK), Brigham and Women's Hospital (US), The University of Sydney (AU), University of Kentucky (US), University of Massachusetts Chan Medical School (US), University of Eastern Finland (FI), University of Rhode Island (US), Pfizer (United States) (US), University of Medicine and Health Sciences (KN), Brown University (US), University of Michigan (US), Karolinska Institutet (SE), Harvard Pilgrim Health Care (US), Michigan Medicine (US), VA Pittsburgh Healthcare System (US), Takeda (United States) (US), Department of Health Services (NP), Department of Health Services (US), Université Laval (CA), Takeda (Japan) (JP), Université de Limoges (FR), University of Pennsylvania (US), IT University of Copenhagen (DK)
International Society for Pharmacoepidemiology, National Institutes of Health, National Institute on Aging, NIH Office of the Director, Office of Disease Prevention
Openalex Percentile: Top 13%
Pharmaceutical Practices and Patient Outcomes
2.07
DOIOpen Access PDFOpenAlex
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