META-ANALYSIS OF PHARMACIST-LED DEPRESCRIBING PROGRAMS REDUCING POLYPHARMACY ADVERSE EVENTS IN OLDER ADULTS
DOI:
https://doi.org/10.71000/b936ze54Keywords:
Adverse Drug Events, Deprescribing, Geriatrics, Hospitalization, Pharmacists, Polypharmacy, Quality of LifeAbstract
Background: Polypharmacy is increasingly prevalent among older adults and is associated with a heightened risk of adverse drug events, hospitalizations, and diminished quality of life. Pharmacist-led deprescribing interventions have emerged as a promising strategy to optimize medication use, yet their collective impact on clinical and patient-centered outcomes remains uncertain.
Objective: To pool randomized and observational evidence evaluating the effect of pharmacist-led deprescribing interventions on adverse drug events, hospitalizations, and quality of life in older adults with polypharmacy.
Methods: A meta-analysis was conducted following PRISMA guidelines, encompassing randomized controlled trials and observational studies published between 2020 and 2025. Data were extracted from PubMed, Scopus, Embase, and the Cochrane Library. The primary outcomes were reductions in adverse drug events and hospitalizations, while secondary outcomes included quality-of-life improvements measured by EQ-5D and SF-36 scores. A random-effects model was applied to estimate pooled risk ratios (RR) and mean differences (MD), with heterogeneity assessed using the I² statistic.
Results: Five eligible studies involving 18,955 participants were analyzed. Pharmacist-led deprescribing significantly reduced adverse drug events (RR = 0.72; 95% CI: 0.60–0.87; p = 0.002; I² = 42%) and hospitalizations (RR = 0.78; 95% CI: 0.65–0.93; p = 0.01; I² = 38%). Quality of life improved modestly (MD = +0.12; 95% CI: 0.04–0.21; p = 0.005; I² = 47%). Intensive pharmacist involvement yielded greater benefits than low-intensity interventions.
Conclusion: Pharmacist-led deprescribing effectively reduces medication-related harm and hospitalizations while improving quality of life among older adults with polypharmacy. Integrating pharmacists into multidisciplinary care frameworks can strengthen medication safety and optimize geriatric care outcomes.
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Copyright (c) 2025 Ahmar Iftikhar, Muhammad Azhar Sherkheli, Durr-e-Shahwar Malik, Mohsin Aziz, Adeel Zain, Muhammad Numair Kashif, Fahad Asim (Author)
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