TY - JOUR
T1 - Recommendations on deprescribing of bisphosphonates in osteoporosis guidelines
T2 - a systematic review
AU - Jepsen, Ditte Beck
AU - Bergen, Emilie Sofie
AU - Pan, Jeffrey
AU - van Poelgeest, Eveline
AU - Osman, Abdiaziz
AU - Burghle, Alaa
AU - Ryg, Jesper
AU - Thompson, Wade
AU - Lundby, Carina
N1 - Publisher Copyright: © 2023, The Author(s), under exclusive licence to European Geriatric Medicine Society.
PY - 2023/8
Y1 - 2023/8
N2 - Purpose: Advancing age, declining health status, and a shift in benefit/risk balance warrant judicious use of preventive medications in older persons, including consideration of deprescribing. Lack of guidance on deprescribing is a major barrier for prescribers to consider deprescribing in daily practice. The aim of this review was to evaluate to what extent osteoporosis guidelines include bisphosphonate deprescribing recommendations. Methodology: We conducted a systematic review, searching PubMed, Embase, and grey literature. We included guidelines on treatment of osteoporosis with bisphosphonates. Two independent reviewers screened titles, abstracts, and full texts. Recommendations for deprescribing were extracted, and quality of guidelines were assessed. Results: Among 9345 references, 42 guidelines were included. A total of 32 (76%) guidelines included deprescribing recommendations: 29 (69%) guidelines included non-specific deprescribing recommendations framed as a drug holiday, of which 2 (5%) also included specific deprescribing recommendations based on individual health context (e.g. life expectancy, frailty, function, preferences/goals). Twenty-four (57%) guidelines included practical deprescribing recommendations, and 27 (64%) guidelines included recommendations for when deprescribing should not be considered. Conclusion: Bisphosphonate deprescribing recommendations in osteoporosis guidelines were primarily framed as drug holidays, with limited guidance on how to make individualized deprescribing decisions based on individual health context. This suggests a need for additional focus on deprescribing in osteoporosis guidelines.
AB - Purpose: Advancing age, declining health status, and a shift in benefit/risk balance warrant judicious use of preventive medications in older persons, including consideration of deprescribing. Lack of guidance on deprescribing is a major barrier for prescribers to consider deprescribing in daily practice. The aim of this review was to evaluate to what extent osteoporosis guidelines include bisphosphonate deprescribing recommendations. Methodology: We conducted a systematic review, searching PubMed, Embase, and grey literature. We included guidelines on treatment of osteoporosis with bisphosphonates. Two independent reviewers screened titles, abstracts, and full texts. Recommendations for deprescribing were extracted, and quality of guidelines were assessed. Results: Among 9345 references, 42 guidelines were included. A total of 32 (76%) guidelines included deprescribing recommendations: 29 (69%) guidelines included non-specific deprescribing recommendations framed as a drug holiday, of which 2 (5%) also included specific deprescribing recommendations based on individual health context (e.g. life expectancy, frailty, function, preferences/goals). Twenty-four (57%) guidelines included practical deprescribing recommendations, and 27 (64%) guidelines included recommendations for when deprescribing should not be considered. Conclusion: Bisphosphonate deprescribing recommendations in osteoporosis guidelines were primarily framed as drug holidays, with limited guidance on how to make individualized deprescribing decisions based on individual health context. This suggests a need for additional focus on deprescribing in osteoporosis guidelines.
KW - Bisphosphonates
KW - Deprescribing
KW - Guidelines
KW - Old age
KW - Osteoporosis
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85163765575&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s41999-023-00820-y
DO - https://doi.org/10.1007/s41999-023-00820-y
M3 - Review article
C2 - 37393587
SN - 1878-7649
VL - 14
SP - 747
EP - 760
JO - European Geriatric Medicine
JF - European Geriatric Medicine
IS - 4
ER -