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

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 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]; I 2 = 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