{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:26:21Z","timestamp":1791897981172,"version":"4.3.4"},"reference-count":113,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Polypharmacy is a major concern among older adults in long-term care facilities (LTCFs), as it increases the risk of potentially inappropriate medications (PIMs) and related adverse outcomes. Medication review and deprescribing interventions may help optimise therapy and reduce harm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was conducted according to PRISMA guidelines (PROSPERO: CRD42023486056). PubMed, Embase and Scopus were searched up to 27 August 2024, for experimental studies evaluating the impact of medication review\/deprescribing interventions in older LTCF residents with polypharmacy. Outcomes included medication appropriateness indexes, falls, hospitalisations and mortality. We calculated risk ratios for dichotomous data and mean differences for continuous data [with 95% confidence intervals (CIs)]. The quality of the studies was assessed using RoB 2 for the randomised controlled trials (RCTs) and the ROBINS-I for non-randomised studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 3548 records, 38 studies (22 RCTs, 16 quasi-experimental) were included. Pooled analyses demonstrated significant reductions in the number of drugs per patient [within 12\u00a0months: \u22120.89 (95% CI \u22121.46, \u22120.32); at \u226512\u00a0months: \u22121.60 (95% CI \u22122.68, \u22120.52)] and in PIMs [at 6\u00a0months: \u22120.48 (95% CI \u22120.74, \u22120.22); at \u226512\u00a0months: \u22120.26 (95% CI \u22120.40, \u22120.13)]. No significant effects were observed on falls, hospitalisations or mortality. Studies showed wide methodological heterogeneity and had moderate to high risk of bias (23 moderate, 14 high, 1 low).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Comprehensive medication review interventions improved prescribing appropriateness in older LTCF residents with polypharmacy but did not significantly affect clinical outcomes (i.e. falls, hospitalisations and mortality). Further high-quality studies using standardised approaches are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afag084","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T12:43:19Z","timestamp":1774356199000},"source":"Crossref","is-referenced-by-count":8,"title":["Evaluating the impact of medication review and deprescribing on prescribing appropriateness and clinical outcomes in older people residing in long-term care facilities: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6523-6036","authenticated-orcid":false,"given":"Massimo","family":"Carollo","sequence":"first","affiliation":[{"name":"Department of Diagnostics and Public Health, University of Verona , Verona, 37134, Veneto ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Cristini","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, University of Verona , Verona, 37134, Veneto ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Crisafulli","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, University of Verona , Verona, 37134, Veneto ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Fontana","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Casa Sollievo della Sofferenza, Unit of Biostatistics, San Giovanni Rotondo , 71013 Apulia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Forti","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, University of Verona , Verona, 37134, Veneto ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"Lanaro","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, University of Verona , Verona, 37134, Veneto ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Maccarrone","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, University of Verona , Verona, 37134, Veneto ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Zerio","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, University of Verona , Verona, 37134, Veneto ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Piccoli","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, University of Verona , Verona, 37134, Veneto ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Poluzzi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Bologna , Bologna, 40138, Emilia-Romagna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziano","family":"Onder","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Orthopedics and Rheumatology, Universit\u00e0 Cattolica del Sacro Cuore , Rome, 00168, Lazio ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1147-7296","authenticated-orcid":false,"given":"Gianluca","family":"Trifir\u00f2","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, University of Verona , Verona, 37134, Veneto ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,12]]},"reference":[{"key":"2026041304210155900_ref1","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1186\/s12877-017-0621-2","article-title":"What is polypharmacy? 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