Development of an evidence-based guideline for deprescribing potentially inappropriate medications in older adults.

OBJECTIVE

To develop an evidence-based guideline for deprescribing potentially inappropriate medications (PIMs) in older adults through systematic evidence synthesis and multidisciplinary expert consensus, providing a standardized framework to support deprescribing practice and pharmaceutical care.

METHODS

Led by the Chinese Medical Association of Clinical Pharmacy and in collaboration with six National Clinical Research Centers for Geriatric Diseases, a multidisciplinary expert panel was established, encompassing geriatrics, clinical pharmacy, nursing, pharmaceutical administration, and pharmacoeconomics. On the basis of an evidence-based framework, a modified Delphi expert consultation method (two rounds) was employed to develop consensus statements. The evidence quality was evaluated via the Joanna Briggs Institute (JBI) Evidence-Based Healthcare tools.

RESULTS

The integrated literature and opinions of Chinese experts led to a deprescribing management process. Named ORDER (includes five steps: organize the list, medication review, develop plan, execute plan, and realize feedback). In addition, we recommend the feasibility and priority of the PIM. This study provides practical recommendations for deprescribing PIM in older adults on the basis of 15 aspects.

CONCLUSION

The ORDER process represents China's first standardized protocol for deprescribing the management of PIM in older adults. Its multidisciplinary collaboration model and patient engagement mechanism provide a scalable pathway to improve rational medication use in geriatric care, offering significant clinical value for advancing comprehensive geriatric assessment systems.