Secondary outcomes
There was minimal data on secondary outcomes from deprescription
interventions in outpatient settings. One study followed patients
receiving regular CGA over 2 years and concluded a significant reduction
in primary care utilization, in addition to a reduction in medication
burden.28 In three pilot studies a reduction in
medication related side-effects was reported34,37,40and reduction in blood pressure was evident after 2 weeks at the heart
failure clinic in a pilot study.38 At the
perioperative clinic no difference in postoperative mortality was noted
3-months after deprescribing intervention39 and after
pharmacist-led deprescribing at the memory clinic, participants did not
appear to experience any change in health outcomes or quality of life at
6-months.37 It is noted that the benefit from
deprescribing interventions on clinical outcomes is not strongly
evidenced from any clinical setting at this stage. Some systematic
reviews have failed to demonstrate any significant benefits from
deprescribing on clinical outcomes.72 A recent review
cited benefits for deprescribing interventions on mental health,
functional status and frailty, but results for cognition and falls were
mixed.73