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重新审视药物减量试验的系统评价,以更好地为未来的实践和研究提供信息。

Revisiting systematic reviews on deprescribing trials to better inform future practice and research.

机构信息

Clinical Pharmacy Research Group, Louvain Drug Research Institute, UCLouvain, Brussels, Belgium.

Pharmacy Department, CHU UCL Namur, Yvoir, Belgium.

出版信息

Br J Clin Pharmacol. 2023 Dec;89(12):3758-3764. doi: 10.1111/bcp.15864. Epub 2023 Aug 17.

Abstract

Deprescribing aims to address the problem of medication overuse in older adults. There has been an increasing number of systematic reviews of 'deprescribing'. We aimed to describe the categories of trials included in recent systematic reviews, and to make recommendations for future research. We categorized 122 trials included in eight recent deprescribing systematic reviews into: discontinuation, deprescribing implementation, medication optimisation (including medication initiation) and non-initiation trials. We identified heterogeneity and inconsistency in the categories of trials included in deprescribing systematic reviews. For example, 39 trials (32.0%) involved medication initiation in addition to the deprescribing component. It is now time for international researchers to develop and validate terminology used for trials involving discontinuation/deprescribing of medications, and to provide recommendations for evidence synthesis that will better inform future research, and translation into practice and policy.

摘要

去处方化旨在解决老年人药物过度使用的问题。越来越多的系统评价对“去处方化”进行了研究。我们旨在描述最近系统评价中包含的试验类别,并为未来的研究提出建议。我们将 8 项去处方化系统评价中纳入的 122 项试验分为:停药、去处方化实施、药物优化(包括药物起始)和非起始试验。我们发现去处方化系统评价中纳入的试验类别存在异质性和不一致性。例如,39 项试验(32.0%)除了去处方化部分外,还涉及药物起始。现在是国际研究人员制定和验证用于涉及药物停药/去处方化试验的术语的时候了,并为证据综合提供建议,这将更好地为未来的研究提供信息,并转化为实践和政策。

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