| Article | Drug/Class | Study design | Sample size | Follow-up (months) | Withdrawal schedule |
Outcome: Mortality
| Study | Drug | Odds ratio (95% CI) | Mean difference (95% CI) |
H2 antagonists
Introduction: current evidence for use and deprescribing of H2 antagonists in older people
Actually maybe this not a good one to start with as not sure we will have as much to say about H2 as say PPI. But idea is that we’d draft a cpl of authoritative paras summarising the evidence base in older ppl here.
The evidence Table summarising the evidence supporting the recommendations for deprescribing of H2 antagonists is presented in Table x.
| Article | Drug/Class | Study design | Sample size | Follow-up (months) | Withdrawal schedule |
Evidence based recommendations
Consensus based recommendations
Proton pump inhibitors
Introduction: current evidence for use and deprescribing of PPIs in older people
The evidence Table summarising the evidence supporting the recommendations for deprescribing of PPIs is presented in Table x.
| Article | Drug/Class | Study design | Sample size | Follow-up (months) | Withdrawal schedule |
| Avraham2018 | PPI | Before-and-after study | 10 | 3 | Halving the dose; initiating famotidine if required |
| Lee 2017 | PPI | Before-and-after study | 28 | 2 | Abrupt discontinuation |
| McDonald 2015 | PPI | Before-and-after study | 209 | Until hospital discharge | At treating physician’s discretion (eg, could be modified, weaned, abruptly discontinued) |
| McIntyre 2017 | Quinine, diuretics, alpha-1 blockers, PPI, statins | Before-and-after study | 240 | 6 | Not described |
| Pratt2017 | PPI | Interrupted time series | Cohort 1 62,460Cohort 2 67,565 | 120 | Not described |
| Reeve2015 | PPI | Before-and-after study | 6 | 6 | Halving the dose every 2 weeks and reducing to as-needed if the participant remained symptom-free on low-dose |
| Wahking2018 | PPI | Retrospective cohort study | 537 | 3 | Abrupt discontinuation or dose reduction |
Outcome: Deprescribing
| Study | Specific outcome | Odds ratio (95% CI) | Mean difference (95% CI) |
| Avraham 2018 | Average medication burden | -4.7 | |
Outcome: Mortality
| Study | Specific outcome | Odds ratio (95% CI) | Mean difference (95% CI) |
Outcome: Exacerbation of underlying condition
| Study | Specific outcome | Odds ratio (95% CI) | Mean difference (95% CI) |
| Avraham 2018 | Symptom assessment scores | -6.1 /100 | |
Evidence based recommendations
Consensus based recommendations
Anti-diabetic medication
Introduction: current evidence for use and deprescribing of anti-diabetic medications in older people
The evidence Table summarising the evidence supporting the recommendations for deprescribing of anti-diabetic medications is presented in Table x.
| Article | Drug/Class | Study design | Sample size | Follow-up (months) | Withdrawal schedule |
| Martin2018 | Z-drugs, benzodiazepines,Glyburide, selective NSAIDs | Cluster RCT | 489 | 6 | Individualised, based on Canadian Deprescribing Network guidance |
| Sjoblom 2008 | Oral hypoglycaemics, insulin | Prospective cohort study | 98 | 6 | Orals/insulin <20 units/day: abrupt discontinuationInsulin >20 units/day: dose halved, then ceased |
Outcome: Deprescribing
| Study | Specific outcome | Odds ratio (95% CI) | Mean difference (95% CI) |
| Sjoblom 2008 | Reinstated medicine | 46.14 (2.56 to 829.87) | |
Outcome: Mortality
| Study | Specific outcome | Odds ratio (95% CI) | Mean difference (95% CI) |
Outcome: Exacerbation of underlying condition
| Study | Specific outcome | Odds ratio (95% CI) | Mean difference (95% CI) |
| Sjoblom 2008 | 20.99 (1.09 to 403.01) | ||
| Sjoblom 2008 | HbA1C | 1.1 (0.58 to 1.62) | |
Evidence based recommendations
Consensus based recommendations
Insulins
Introduction: current evidence for use and deprescribing of insulin in older people
The evidence Table summarising the evidence supporting the recommendations for deprescribing of insulin is presented in Table x.
| Article | Drug/Class | Study design | Sample size | Follow-up (months) | Withdrawal schedule |
| Hansen2017 | Insulin | Before-and-after study | 20 | Mean 6 | Not described |
| Sjoblom 2008 | Oral hypoglycaemics, insulin | Prospective cohort study | 98 | 6 | Orals/insulin <20 units/day: abrupt discontinuationInsulin >20 units/day: dose halved, then ceased |
Outcome: Mortality
| Study | Drug | Odds ratio (95% CI) | Mean difference (95% CI) |
Evidence based recommendations
Consensus based recommendations
Biguanides
Introduction: current evidence for use and deprescribing of biguanides in older people
The evidence Table summarising the evidence supporting the recommendations for deprescribing of biguanides is presented in Table x.
| Article | Drug/Class | Study design | Sample size | Follow-up (months) | Withdrawal schedule |
| Leyco2017 | Metformin | Retrospective cohort stury | 69 | 6 | Not described |
Outcome: Mortality
| Study | Drug | Odds ratio (95% CI) | Mean difference (95% CI) |
Evidence based recommendations
Consensus based recommendations
Dulphylurea
Introduction: current evidence for use and deprescribing of dulphylurea in older people
The evidence Table summarising the evidence supporting the recommendations for deprescribing of dulphylurea is presented in Table x.
| Article | Drug/Class | Study design | Sample size | Follow-up (months) | Withdrawal schedule |
Evidence based recommendations
Consensus based recommendations
DPP-4 inhibitors
Introduction: current evidence for use and deprescribing of DPP-4 inhibitors in older people
The evidence Table summarising the evidence supporting the recommendations for deprescribing of DPP-4 inhibitors is presented in Table x.
| Article | Drug/Class | Study design | Sample size | Follow-up (months) | Withdrawal schedule |