Table 1.
Summary of deprescribing studies during the preoperative period (n=16)
| Author, year | Study Design, Level of Evidence1 | Age (yrs) | Country | Procedure Type | Intervention Setting | Intervention | Target Medication Classes | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ER | ELC | OGT | UC | Clinic | Inpatient | IDT | PharmD | GERI | EMR/Tool | UC | Blood | HTN | AC | PPI | AD | AN | NSAID | BRC | STA | AE | Thy | ||||
| Randomized controlled trials | |||||||||||||||||||||||||
| Heltne, 2017 | RCT N=397 •Level I A• |
IG=83.4 CG=83.2 |
Norway | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | |||||||||||||
| Boersma, 2019 | RCT, cluster N=65 •Level I A• |
IG=77.8 CG=79 |
The Netherlands | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ||||||||||||||
| Quasi-experimental studies | |||||||||||||||||||||||||
| Cronin, 2011 | Quasi-Exp N=69 •Level II A• |
Mean 76.8 | US | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ||||||||||||||
| Hohn, 2014 | Quasi-Exp N=105 •Level II A• |
>=65 (47%) | Germany | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | |||||||||||||
| Al-Jazairi, 2017 | Quasi-Exp study N=184 (adults) N=190 (pediatrics) •Level III A• |
Adults Mean 53.8 | Saudi Arabia | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | |||||||||||
| Cortez, 2018 | Quasi-Exp N=177 •Level II A• |
Mean 80.1 | US | ★ | ★ | ★ | ★ | ★ | ★ | ||||||||||||||||
| Mason, 2018 | Quasi-ExP N=447 •Level II A• |
Mean 81 | UK | ★ | ★ | ★ | ★ | ||||||||||||||||||
| Shafiekhani, 2019 | Quasi-Exp N=495 •Level II A• |
Mean 60.4 | Iran | ★ | ★ | ★ | ★ | ★ | ★ | ||||||||||||||||
| Zulig, 2019 | Quasi-Exp N=44 •Level II A• |
Mean 71.5 | US | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ||||||||||||||
| Observational studies | |||||||||||||||||||||||||
| Vilches-Moraga, 2017 | Cohort study N=300 •Level III A• |
Mean 82.5 | UK | ★ | ★ | ★ | ★ | ★ | |||||||||||||||||
| Lin, 2018 | Cohort study N=48 •Level III A• |
Mean 70.9 | US | ★ | ★ | ★ | ★ | ||||||||||||||||||
| McDonald, 2018 | Case-control N=183 •Level III A• |
IG=75.6 CG=71.9 |
US | ★ | ★ | ★ | ★ | ★ | |||||||||||||||||
| Bansal, 2019 | Cohort study N=246 •Level III A• |
>=60 (83.8 %) | UK | ★ | ★ | ★ | ★ | ★ | |||||||||||||||||
| Gleich, 2019 | Cohort study N=95 •Level III A• |
IG=83.39 CG=81.54 |
Germany | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | |||||||||||||
| Kimura, 2019 | Cohort study N=230 •Level III A• |
Mean 75.4 | Japan | ★ | ★ | ★ | ★ | ★ | ★ | ★ | |||||||||||||||
| Mehta, 2020 | Cohort study N=470 •Level III A• |
Mean 78.6 | Canada | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | ★ | |||||||||||||
†
Level of evidence assessed with Johns Hopkins Nursing Evidence Appraisal Tool (Appendix E)
†
Procedure Type: ER- Emergency, ELC- Elective, OGT- Orthogeriatric Trauma, UC- Unclear
†
Intervention: IDT- interdisciplinary team, GERI- Geriatrician
†
Target Medication Classes: UC- Unclear, Blood- Blood thinners (anticoagulants/antiplatelets), Htn- Antihypertensive, AC- Anticholinergics, PPI- Proton Pump Inhibitors, AD- Antidepressants, AN- Analgesics, NSAID- Anti-inflammatories, BRC- Bronchodilators, STA- Statins, AE- Antiepileptics, Thy- Thyroid agents