Effectiveness and safety of deprescribing interventions in older adults with polypharmacy: a review of clinical trials from 2017 to 2026

Abstract

Background. Population aging contributes to the rising prevalence of multimorbidity and polypharmacy, which increase the risk of adverse drug events and deterioration in quality of life among older adults. Deprescribing is a planned process of treatment optimization aimed at reducing unnecessary medication burden and improving patient well-being. 

Aim. The objective of this study is to summarize current scientific evidence on the clinical effectiveness and safety of deprescribing interventions in older adults based on a review of clinical trials published between 2017 and 2026. 

Material and methods. A review of English-language clinical trials published between 2017 and 2026 was conducted using the PubMed and Google Scholar databases, with the following search terms: “deprescribing,” “polypharmacy,” “inappropriate prescribing” and “potentially inappropriate.” Studies assessing the safety and clinical outcomes of deprescribing in individuals aged 65 years and older with polypharmacy were included.

Results. Deprescribing appears to have a neutral effect on mortality and hospitalizations, supporting the safety of this intervention. Its impact on the incidence of falls in older adults remains inconclusive. At the same time, improvements in quality of life, functional status, and selected cognitive functions are observed, particularly following the reduction of central nervous system–acting medications and drugs with anticholinergic properties.

Conclusions. Deprescribing is a safe treatment strategy that improves selected aspects of patient functioning. Rational medication selection, rather than the total number of medications, is of key importance. Future studies should incorporate extended follow-up periods to better assess long-term health outcomes.