Development of an evidence-based guideline for deprescribing potentially inappropriate medications in older adults
To develop an evidence-based guideline for deprescribing potentially inappropriate medications (PIMs) in older adults through systematic evidence synthesis and multidisciplinary expert consensus, providing a standardized framework to support deprescribing practice and pharmaceutical care. Led by the Chinese Medical Association of Clinical Pharmacy and in collaboration with six National Clinical Research Centers for Geriatric Diseases, a multidisciplinary expert panel was established, encompassing geriatrics, clinical pharmacy, nursing, pharmaceutical administration, and pharmacoeconomics. On the basis of an evidence-based framework, a modified Delphi expert consultation method (two rounds) was employed to develop consensus statements. The evidence quality was evaluated via the Joanna Briggs Institute (JBI) Evidence-Based Healthcare tools. The integrated literature and opinions of Chinese experts led to a deprescribing management process. Named ORDER (includes five steps: organize the list, medication review, develop plan, execute plan, and realize feedback). In addition, we recommend the feasibility and priority of the PIM. This study provides practical recommendations for deprescribing PIM in older adults on the basis of 15 aspects. The ORDER process represents China’s first standardized protocol for deprescribing the management of PIM in older adults. Its multidisciplinary collaboration model and patient engagement mechanism provide a scalable pathway to improve rational medication use in geriatric care, offering significant clinical value for advancing comprehensive geriatric assessment systems.
Authors
- Xuehua Wan (ORCID: https://orcid.org/0000-0002-6367-848X)
- Fengsu Hou (ORCID: https://orcid.org/0000-0001-5869-4365)
- Shuang Zhou (ORCID: https://orcid.org/0000-0002-3925-5479)
- Lei Tian (ORCID: https://orcid.org/0000-0002-1929-3953)
- Yanqing Song (ORCID: https://orcid.org/0000-0001-6725-3342)
- Xinan Wu (ORCID: https://orcid.org/0000-0002-3211-9730)
- Hang Wang (ORCID: https://orcid.org/0000-0002-0081-9396)
- Jinhan He (ORCID: https://orcid.org/0000-0001-6487-4696)
- Daihong Guo (ORCID: https://orcid.org/0000-0002-7456-0399)
- Ling Liu (ORCID: https://orcid.org/0000-0001-8902-6001)
- Pengfei Jin
- Xiao Chen (ORCID: https://orcid.org/0000-0002-8354-9087)
- Yongfang Yuan (ORCID: https://orcid.org/0000-0003-1123-2379)
- Qiyi Feng (ORCID: https://orcid.org/0000-0003-1437-644X)
- Haibin Dai (ORCID: https://orcid.org/0000-0002-5768-2714)
- Xiaodong Guan (ORCID: https://orcid.org/0000-0002-1290-3827)
- Bo Zhang (ORCID: https://orcid.org/0000-0002-7331-1550)
- Shao Liu (ORCID: https://orcid.org/0000-0002-0576-8698)
- Fangyuan Tian (ORCID: https://orcid.org/0000-0002-5187-0386)
- Rui Tang (ORCID: https://orcid.org/0000-0003-3118-3842)
- Fei Zhou (ORCID: https://orcid.org/0000-0002-8691-916X)
- Xueyi Zhang (ORCID: https://orcid.org/0009-0004-4012-2755)
- Zhaoyan Chen (ORCID: https://orcid.org/0000-0002-0181-1564)
- Xiaolan Bian (ORCID: https://orcid.org/0009-0001-1151-9057)
- Anhua Wei
- Lingji Hao
- Shili Liao
- Ling Jiang (ORCID: https://orcid.org/0000-0002-6589-1399)
- Xi Chen (ORCID: https://orcid.org/0000-0003-2390-5104)
- Hongyu Cai
- Bikui Zhang
- Liyan Miao
- Shilong Zhong
- Jie Zhang
- Ruigang Hou
- Bin Wu
- Yujin Guo
- Feng Qiu
- Yuyan Wang
- Xingguo Zhang
- Lan Zhang
- Li Mo
- Mei Wang
- Benzhi Cai
- Jingwen Wang
- Rongsheng Zhao
- the Consensus Panel and the Evidence Synthesis Group
- Yuxian Chen
- Qian Chen
- Aizong Shen
- Lingyan Zhou
- Ying Zhang
- Ming Hu
- Hui Wu
- Xiaocong Zuo
- Zinan Zhao
- Yu Zhang
- Jie Zhao
- Weihua Lai
- Jianfen Gu
- Yinghui Jin
- Mengnan Zhao
- Lihong Liu
- Dan Zhou
- Lu Yang
- Fengbo Wu
- Zhiren Zhang
- Bin Wang
- Hong Li
- Jian Zhang
- Jianhua Yang
- Ying Zhou
- Dong Liu
Institutions
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- Peking University (CN)
- Sichuan University (CN)
- West China Medical Center of Sichuan University (CN)
- West China Hospital of Sichuan University (CN)
- Chongqing Academy of Environmental Science (CN)
- Chongqing Academy of Science and Technology (CN)
- Peking University First Hospital (CN)
- Tibet Autonomous Region People's Hospital (CN)
- National Center for Clinical Laboratories (CN)
Publication Details
- Journal
- BMC Geriatrics
- Published
- 2026-09-21
- DOI
- https://doi.org/10.1186/s12877-026-08324-7
- Primary Topic
- Pharmaceutical Practices and Patient Outcomes
- Type
- article
- Field-Weighted Citation Impact
- 0.00