NEW DELHI: An analysis of previously published studies has found that de-prescribing preventive medications among old, frail adults did not increase the risk of death, hospitalisation, or major heart-related events.
Findings published in the journal BioMed Central (BMC) Geriatrics also suggest that de-prescribing was not related to an increased risk of falls -- a leading cause of disability among older adults -- fractures, or a reduced quality of life.
Researchers, including those from the Indian Council of Medical Research-National Institute for Research in Bacterial Infections, Kolkata, and Sweden's Karolinska Institutet, added, however, that evidence certainty -- a measure of confidence that the true effect of de-prescribing is close to one estimated from research -- was low and more studies are required.
Frail, older adults having a limited life expectancy are commonly prescribed long-term preventive medications and concurrent multiple medications -- "polypharmacy" -- despite uncertain benefits and potential risks, the team said.
They analysed 15 studies, involving more than 33,000 participants and taken from databases including the 'PubMed' and 'Web of Science'.
The analysis produced evidence on the effect of de-prescribing preventive medications, such as antihypertensives, statins and antidiabetics, compared to continuing clinical, physiological, safety, and patient-centred outcomes among older adults with advanced frailty, dementia, or limited life expectancy.
"De-prescribing preventive medications in frail or palliative older adults was not associated with worse outcomes; however, evidence certainty was very low, and further studies are needed," the authors wrote.
"From 10,397 records, 15 studies were included. Overall, de-prescribing was not associated with increased risk of all-cause mortality, hospitalisation, or MACE (major adverse cardiovascular event) (certainty: very low GRADE)," they said.
"De-prescribing was also not associated with increased risks of fracture, fall, or deterioration of quality of life, but with slightly increased systolic blood pressure (deprescribing antihypertensives)," they said.