Evaluation of real-world evidence to assess health outcomes related to deprescribing medications in older adults

Authors

• Kaleen N. Hayes, United States Department of Health and Human ServicesFollow
• Joshua David Niznik, University of North Carolina at Chapel Hill
• Danijela Gnjidic, University of Sydney
• Frank Moriarty, Royal College of Surgeons in Ireland (RCSI)
• Nha Tran, University of Michigan, Ann Arbor
• Antoinette B. Coe, University of Michigan, Ann Arbor
• Andrew R. Zullo, Brown University
• Sirui Zhang, United States Department of Health and Human Services
• Matthew Alcusky, University of Massachusetts Medical School
• Dimitri Bennett, Perelman School of Medicine
• Sirpa Hartikainen, University of Copenhagen
• Marie Laure Laroche, CHU de Limoges
• Xiaojuan Li, Harvard University
• Joshua K. Lin, Harvard University
• Jennifer L. Lund, University of North Carolina Chapel Hill
• Maurizio Sessa, University of Copenhagen
• Shahar Shmuel, Pfizer
• Caroline Sirois, Université Laval
• Denis Talbot, Université Laval
• Miia Tiihonen, Karolinska Institutet
• Xuerong Wen, University of Rhode Island
• Mouna J. Sawan, University of Sydney
• Daniela C. Moga, University of KentuckyFollow

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.

Document Type

Article

Publication Date

8-1-2025

Notes/Citation Information

Publisher Copyright: © The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Digital Object Identifier (DOI)

10.1093/aje/kwae425

Archival?

Archival

Repository Citation

Hayes, Kaleen N.; Niznik, Joshua David; Gnjidic, Danijela; Moriarty, Frank; Tran, Nha; Coe, Antoinette B.; Zullo, Andrew R.; Zhang, Sirui; Alcusky, Matthew; Bennett, Dimitri; Hartikainen, Sirpa; Laroche, Marie Laure; Li, Xiaojuan; Lin, Joshua K.; Lund, Jennifer L.; Sessa, Maurizio; Shmuel, Shahar; Sirois, Caroline; Talbot, Denis; Tiihonen, Miia; Wen, Xuerong; Sawan, Mouna J.; and Moga, Daniela C., "Evaluation of real-world evidence to assess health outcomes related to deprescribing medications in older adults" (2025). Epidemiology and Environmental Health Faculty Publications. 153.
https://uknowledge.uky.edu/epidemiology_facpub/153