Deprescribing interventions among community dwelling older adults

Bibliographic Details
Main Author: Romano, Sónia
Publication Date: 2021
Other Authors: Figueira, Débora, Teixeira, Inês, Perelman, Julian
Format: Other
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10362/129895
Summary: Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
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spelling Deprescribing interventions among community dwelling older adultsa systematic review of economic evaluationsPharmacologyHealth PolicyPublic Health, Environmental and Occupational HealthSDG 3 - Good Health and Well-beingPublisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.Background: Deprescribing can reduce the use of inappropriate or unnecessary medication; however, the economic value of such interventions is uncertain. Objective: This study seeks to identify and synthetise the economic evidence of deprescribing interventions among community-dwelling older adults. Methods: Full economic evaluation studies of deprescribing interventions, conducted in the community or primary care settings, in community-dwelling adults aged ≥ 65 years were systematically reviewed. MEDLINE, EconLit, Scopus, Web of Science, CEA-TUFTS, CRD York and Google Scholar databases were searched from inception to February 2021. Two researchers independently screened all retrieved articles according to inclusion and exclusion criteria. The main outcome was the economic impact of the intervention from any perspective, converted into 2019 US Dollars. The World Health Organization threshold of 1 gross domestic product per capita was used to define cost effectiveness. Studies were appraised for methodological quality using the extended Consensus on Health Economics Criteria checklist. Results: Of 6154 articles identified by the search strategy, 14 papers assessing 13 different interventions were included. Most deprescribing interventions included some type of medication review with or without a supportive educational component (n = 11, 85%), and in general were delivered within a pharmacist-physician care collaboration. Settings included community pharmacies, primary care/outpatient clinics and patients’ homes. All economic evaluations were conducted within a time horizon varying from 2 to 12 months with outcomes in most of the studies derived from a single clinical trial. Main health outcomes were reported in terms of quality-adjusted life-years, prevented number of falls and the medication appropriateness index. Cost effectiveness ranged from dominant to an incremental cost-effectiveness ratio of $112,932 per quality-adjusted life-year, a value above the country’s World Health Organization threshold. Overall, 85% of the interventions were cost saving, dominated usual care or were cost effective considering 1 gross domestic product per capita. Nine studies scored > 80% (good) and two scored ≤ 50% (low) on critical quality appraisal. Conclusions: There is a growing interest in economic evaluations of deprescribing interventions focused on community-dwelling older adults. Although results varied across setting, time horizon and intervention, most were cost effective according to the World Health Organization threshold. Deprescribing interventions are promising from an economic viewpoint, but more studies are needed.Escola Nacional de Saúde Pública (ENSP)Centro de Investigação em Saúde Pública (CISP/PHRC)RUNRomano, SóniaFigueira, DéboraTeixeira, InêsPerelman, Julian2021-12-28T02:08:58Z20222022-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/otherapplication/pdfhttp://hdl.handle.net/10362/129895eng1170-7690PURE: 35606086https://doi.org/10.1007/s40273-021-01120-8info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2024-05-22T17:57:48Zoai:run.unl.pt:10362/129895Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T17:29:04.003324Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Deprescribing interventions among community dwelling older adults
a systematic review of economic evaluations
title Deprescribing interventions among community dwelling older adults
spellingShingle Deprescribing interventions among community dwelling older adults
Romano, Sónia
Pharmacology
Health Policy
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
title_short Deprescribing interventions among community dwelling older adults
title_full Deprescribing interventions among community dwelling older adults
title_fullStr Deprescribing interventions among community dwelling older adults
title_full_unstemmed Deprescribing interventions among community dwelling older adults
title_sort Deprescribing interventions among community dwelling older adults
author Romano, Sónia
author_facet Romano, Sónia
Figueira, Débora
Teixeira, Inês
Perelman, Julian
author_role author
author2 Figueira, Débora
Teixeira, Inês
Perelman, Julian
author2_role author
author
author
dc.contributor.none.fl_str_mv Escola Nacional de Saúde Pública (ENSP)
Centro de Investigação em Saúde Pública (CISP/PHRC)
RUN
dc.contributor.author.fl_str_mv Romano, Sónia
Figueira, Débora
Teixeira, Inês
Perelman, Julian
dc.subject.por.fl_str_mv Pharmacology
Health Policy
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
topic Pharmacology
Health Policy
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
description Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
publishDate 2021
dc.date.none.fl_str_mv 2021-12-28T02:08:58Z
2022
2022-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/other
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status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/129895
url http://hdl.handle.net/10362/129895
dc.language.iso.fl_str_mv eng
language eng
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https://doi.org/10.1007/s40273-021-01120-8
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instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
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