What may work in deprescribing? A scoping review of intervention types, targets and outcomes

Abstract Background: The overuse of medications, especially in older populations, is a growing public health concern. Not only does inappropriate prescribing contribute to adverse drug reactions, but it also results in significant economic and environmental impacts. The process of deprescribing, or the systematic reduction or cessation of medications, aims to improve health outcomes and address the risks associated with polypharmacy. Objective: This scoping review seeks to map the various types of deprescribing interventions, their target populations, and the outcomes associated with these interventions. It provides an initial assessment of their effectiveness and synthesizes evidence from multiple disciplines to inform broader public health strategies. Methods: A comprehensive literature search was conducted using PubMed and Web of Science to identify studies from 2010 onward that evaluated deprescribing interventions. The review includes interventions targeting different patient populations, healthcare settings, and medication types, with data extracted on intervention characteristics and outcomes. Results: Of the 179 studies included, the majority focused on older adults, with a significant number targeting polypharmacy. Most interventions involved provider-focused strategies, including education and medication reviews, with some also engaging patients directly through educational materials. Pharmacists played a key role in many effective interventions. While outcomes varied, interventions consistently demonstrated positive impacts on medication reduction and patient safety, with minimal adverse effects. Conclusion: This review highlights the importance of multidisciplinary approaches, patient involvement, and guideline-based tools in effective deprescribing. The findings support the implementation of deprescribing interventions as a public health strategy to reduce medication-related harm and contribute to environmental sustainability. However, further research is needed to assess long-term efficacy, the impact on younger populations, and the environmental outcomes of deprescribing.