{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:14:51Z","timestamp":1790817291358,"version":"4.1.0"},"reference-count":58,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Polypharmacy is highly prevalent among older adults and is associated with adverse outcomes. While comprehensive medication review is widely promoted to address potentially inappropriate prescribing, it is resource intensive. Focused deprescribing\u2014defined as the targeted withdrawal or dose reduction of specific drug classes\u2014has emerged as a potentially more scalable strategy. This umbrella review synthesised evidence on the effectiveness and safety of drug class-specific focused deprescribing interventions in older adults. We conducted an umbrella review of systematic reviews evaluating focused deprescribing interventions targeting specific pharmacological classes. MEDLINE, Embase, the Cochrane Library and Web of Science were searched from inception to March 2025. Study selection, data extraction and methodological quality assessment (AMSTAR-2) were performed independently by two reviewers. Findings were synthesised narratively by drug class and outcome domain, and overlap was assessed using the Corrected Covered Area. Twenty-seven systematic reviews were included. Most focused on psychotropics, particularly benzodiazepines, and anticholinergics, with fewer assessing antidiabetics or fall-risk increasing drugs. Reductions in medication use were most consistent for benzodiazepines and other psychotropics, especially when interventions included psychotherapy or multifaceted components. Evidence for antidiabetics suggested feasibility and safety, whereas effects on anticholinergics and fall-risk increasing drugs were limited. Clinical outcomes, including mortality, falls and cognition, were inconsistently reported and rarely improved. Most reviews were rated as critically low quality, and certainty of evidence was generally low or very low. Focused deprescribing appears feasible and generally safe for reducing selected potentially inappropriate medications in older adults; however, its clinical benefits are drug class-dependent and remain uncertain.<\/jats:p>","DOI":"10.1093\/ageing\/afag243","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:11:44Z","timestamp":1785237104000},"source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness and safety of focused deprescribing interventions targeting specific drug classes in older adults across clinical settings: an umbrella systematic literature review"],"prefix":"10.1093","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9348-2579","authenticated-orcid":false,"given":"\u00c1ngel","family":"Garc\u00eda \u00c1lvarez","sequence":"first","affiliation":[{"name":"Central Pharmacy Service, Balearic Islands Health Service , Palma, Autonomous Community of the Balearic Islands ,","place":["Spain"]},{"name":"Research Group, Atenci\u00f3n Primaria, Servicios de Salud, y Medicina Basada en la Evidencia (EVISAP) , , Palma, Autonomous Community of the Balearic Islands ,","place":["Spain"]},{"name":"IdISBa , , Palma, Autonomous Community of the Balearic Islands ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pau","family":"Riera Serra","sequence":"additional","affiliation":[{"name":"Research Group, Atenci\u00f3n Primaria, Servicios de Salud, y Medicina Basada en la Evidencia (EVISAP) , , Palma, Autonomous Community of the Balearic Islands ,","place":["Spain"]},{"name":"IdISBa , , Palma, Autonomous Community of the Balearic Islands ,","place":["Spain"]},{"name":"Cochrane Balearic Islands , Palma, Autonomous Community of the Balearic Islands ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"Ricci-Cabello","sequence":"additional","affiliation":[{"name":"Research Group, Atenci\u00f3n Primaria, Servicios de Salud, y 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Islands,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela C","family":"Gon\u00e7alves-Bradley","sequence":"additional","affiliation":[{"name":"Cochrane Balearic Islands , Palma, Autonomous Community of the Balearic Islands ,","place":["Spain"]},{"name":"Institute of Psychology, University of P\u00e9cs Faculty of Humanities and Social Sciences , P\u00e9cs, Baranya ,","place":["Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Gallardo-Alfaro","sequence":"additional","affiliation":[{"name":"Majorca Primary Care Management , Palma, Autonomous Community of the Balearic Islands ,","place":["Spain"]},{"name":"Research group in Primary Care and Promotion (GRAPP-CAIB), IdISBa , Palma, Autonomous Community of the Balearic Islands ,","place":["Spain"]},{"name":"Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) , Barcelona 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Primary Care Management , Palma, Autonomous Community of the Balearic Islands ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Pinte\u00f1o-Blanco","sequence":"additional","affiliation":[{"name":"Pharmacy Service, Hospital Comarcal d'Inca , Inca, Autonomous Community of the Balearic Islands ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Medina Bombard\u00f3","sequence":"additional","affiliation":[{"name":"Centre de Salut Sa Torre de Manacor, Primary Care Department of Mallorca, Balearic Islands Health Service (IB-Salut), Manacor, Autonomous Community of the Balearic Islands ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Angela","family":"Doronzo","sequence":"additional","affiliation":[{"name":"Preventive Medicine Service, Hospital Universitario Son Espases, Palma, Autonomous Community of the Balearic Islands 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