Robyn Gillespie|Lindsey Harrison|Judy Mullan
Deprescribing medications for older adults in the primary care context: A mixed studies review
University of Wollongong|University of Wollongong|University of Wollongong
abstract aims review investigates factors influence deprescribing medications primary care perspective general practitioners gps communityliving older adults methods mixed studies review structure adopted searching scopus cinahl psychinfo proquest pubmed january 2000 december 2017 manual search reference lists also conducted studies included original research available english explored general deprescribing rather deprescribing specific class medications mixed methods assessment tool used assess quality studies content analysis generated common categories across studies results thirtyeight articles included 7 key categories identified review found factors influence deprescribing similar across within health systems mostly act barriers factors remained unchanged across review period structural organisation health systems remains poorly suited facilitate deprescribing individual knowledge gaps gps older adults influence practices attitudes towards deprescribing significant communication gaps occur gps specialists gps older adults result deprescribing decision making characterised uncertainty deprescribing often considered medication problems already arisen trust plays complex role acting barrier facilitator deprescribing conclusions deprescribing influenced many factors despite recent interest little change occurred multilevel strategies aimed reforming aspects health system managing uncertainty practice individual level notably reducing knowledge limitations closing communications gaps may achieve change