Pharmacists' contribution to benzodiazepine deprescribing in older outpatients: a systematic review and meta-analysis.

Autor: Melo TAR; Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 580, Conj. das Químicas, Bloco 13, Cidade Universitária Butantã, São Paulo, Brazil., Bezerra CO; Municipal Health Department, Multiprofessional Residency Program in Family and Community Health, João Pessoa, PB, Brazil., Fernandes BD; Capixaba Institute of Health Education, Research and Innovation, Vitória, ES, Brazil., Rotta I; Department of Pharmacy, Federal University of Paraná, Curitiba, PR, Brazil., Reis WCT; Department of Pharmaceutical Sciences, Health Sciences Center, Federal University of Paraíba, João Pessoa, PB, Brazil., Aguiar PM; Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 580, Conj. das Químicas, Bloco 13, Cidade Universitária Butantã, São Paulo, Brazil. aguiar.pm@usp.br.
Jazyk: angličtina
Zdroj: International journal of clinical pharmacy [Int J Clin Pharm] 2023 Oct; Vol. 45 (5), pp. 1037-1049. Date of Electronic Publication: 2023 Sep 15.
DOI: 10.1007/s11096-023-01637-2
Abstrakt: Background: Consolidated and reliable evidence regarding the effectiveness of pharmacist interventions for deprescribing benzodiazepines in older outpatients is lacking.
Aim: This study evaluated and summarized the impact of pharmacist interventions on benzodiazepine deprescribing among older outpatients.
Method: A literature search was conducted until August 2022 in PubMed, PsycINFO, and the Cochrane Central Register of Controlled Trials databases. The review included randomized controlled trials that assessed the impact of pharmacist interventions on deprescribing benzodiazepine in older outpatients. Two independent investigators conducted the study selection, data extraction, and risk of bias assessment. Meta-analyses were conducted using random-effect models in the RStudio software.
Results: A total of 893 records were identified. Five studies, including 3,879 patients, met the inclusion criteria and were included in the systematic review. All five studies used health education as an intervention strategy, and three also conducted medication reviews. There was no evidence of the pharmacist's authority to modify prescriptions during benzodiazepine deprescribing. One study was classified as having a low risk of bias, whereas the other had some concerns or a high risk of bias. Three studies were included in the meta-analysis and a significant impact of pharmacist interventions on benzodiazepines deprescribing rates in older outpatients was observed (RR = 2.75 [95%CI 1.29; 5.89]; p = 0.04; I 2  = 69%; low certainty of evidence).
Conclusion: Pharmacists may contribute to deprescribing benzodiazepines in older outpatients. Further studies are needed to increase the reliability of these findings. PROSPERO registration number: CRD42022358563.
(© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Databáze: MEDLINE
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