Deprescribing Tools in Primary Care: A Critical Review and the Pivotal Role of the Community Pharmacist.

Introduction

Deprescribing is crucial for improving pharmacotherapeutic safety in polymedicated patients, a common profile in community pharmacy. However, a gap exists between the available evidence and real-world clinical practice.

Objective

This review aimed to identify and critically analyze validated deprescribing tools, assessing their applicability in the community setting and highlighting the leading role the pharmacist can assume. Material and

Methods

A critical narrative review was conducted via a literature search in PubMed/MEDLINE and LILACS, period 2014-2024, using the terms MeSH Deprescribing AND Inappropriate prescription, OR Inappropriate Medicaments. Tools with psychometric and/or clinical validation were included. Two independent reviewers screened studies, and discrepancies were resolved by consensus.

Results

Out of 71 screened studies, 23 were included. We identified 5 updated clinical criteria, 9 specific tools for pharmacological groups, and 9 attitudinal questionnaires. Technical maturity in tools is evident, but critical gaps persist: therapeutic fragmentation, absence of Spanish validation for key instruments, and the exclusion of the community pharmacist from many of them. A key finding is the high willingness to deprescribe among patients (87.6%) and caregivers (74.8%).

Conclusions

We conclude that the community pharmacist, due to their accessibility and holistic view of medication, is the ideal professional to drive deprescribing.