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. 2022 Feb;88(2):452-463.
doi: 10.1111/bcp.14947. Epub 2021 Jul 2.

Community-based pharmacists' role in deprescribing: A systematic review

Iva Bužančić  1   2 , Ingrid Kummer  3 , Margita Držaić  1   2 , Maja Ortner Hadžiabdić  2
Affiliations
Free article

Community-based pharmacists' role in deprescribing: A systematic review

Iva Bužančić et al. Br J Clin Pharmacol. 2022 Feb.
Free article

Abstract

Aims: Community-based pharmacists are an important stakeholder in providing continuing care for chronic multi-morbid patients, and their role is steadily expanding. The aim of this study is to examine the literature exploring community-based pharmacist-initiated and/or -led deprescribing and to evaluate the impact on the success of deprescribing and clinical outcomes.

Methods: Library and clinical trials databases were searched from inception to March 2020. Studies were included if they explored deprescribing in adults, by community-based pharmacists and were available in English. Two reviewers extracted data independently using a pre-agreed data extraction template. Meta-analysis was not performed due to heterogeneity of study designs, types of intervention and outcomes.

Results: A total of 24 studies were included in the review. Results were grouped based on intervention method into four categories: educational interventions; interventions involving medication review, consultation or therapy management; pre-defined pharmacist-led deprescribing interventions; and pharmacist-led collaborative interventions. All types of interventions resulted in greater discontinuation of medications in comparison to usual care. Educational interventions reported financial benefits as well. Medication review by community-based pharmacist can lead to successful deprescribing of high-risk medication, but do not affect the risk or rate of falls, rate of hospitalisations, mortality or quality of life. Pharmacist-led medication review, in patients with mental illness, resulting in deprescribing improves anticholinergic side effects, memory and quality of life. Pre-defined pharmacist-led deprescribing did not reduce healthcare resource consumptions but can contribute to financial savings. Short follow-up periods prevent evaluation of long-term sustainability of deprescribing interventions.

Conclusion: This systematic review suggests community-based pharmacists can lead deprescribing interventions and that they are valuable partners in deprescribing collaborations, providing necessary monitoring throughout tapering and post-follow-up to ensure the success of an intervention.

Keywords: community pharmacist; community-based pharmacist; cost evaluation; deprescribing; medication; outcomes; systematic review.

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References

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