Abstract：
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.
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.
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.
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.
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.
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.
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.
摘要：
目标：提高年龄，健康状况下降，利益/风险平衡的转变保证了老年人明智地使用预防性药物，包括取消处方的考虑。缺乏关于开处方的指导是处方者在日常实践中考虑开处方的主要障碍。这篇综述的目的是评估骨质疏松症指南在多大程度上包括双膦酸盐处方建议。
方法：我们进行了系统评价，搜索PubMed,Embase,灰色文学我们纳入了用双膦酸盐治疗骨质疏松症的指南。两名独立审稿人筛选了标题，摘要,和全文。提出了取消处方的建议，并对指南的质量进行了评估。
结果：在9345篇参考文献中，包括42条准则。共有32项（76％）指南包括开处方建议：29项（69％）指南包括非特定的开处方建议，将其定为毒品假期，其中2(5%)还包括基于个人健康状况的具体处方建议(例如预期寿命，脆弱,函数,偏好/目标)。二十四（57％）指南包括实际的开药建议，和27(64%)指南包括建议何时不应考虑开处方.
结论：骨质疏松症指南中的双膦酸盐处方建议主要是作为药物假期，关于如何根据个人健康状况做出个性化处方决定的指导有限。这表明需要在骨质疏松症指南中进一步关注处方。
方法：我们进行了系统评价，搜索PubMed,Embase,灰色文学我们纳入了用双膦酸盐治疗骨质疏松症的指南。两名独立审稿人筛选了标题，摘要,和全文。提出了取消处方的建议，并对指南的质量进行了评估。
结果：在9345篇参考文献中，包括42条准则。共有32项（76％）指南包括开处方建议：29项（69％）指南包括非特定的开处方建议，将其定为毒品假期，其中2(5%)还包括基于个人健康状况的具体处方建议(例如预期寿命，脆弱,函数,偏好/目标)。二十四（57％）指南包括实际的开药建议，和27(64%)指南包括建议何时不应考虑开处方.
结论：骨质疏松症指南中的双膦酸盐处方建议主要是作为药物假期，关于如何根据个人健康状况做出个性化处方决定的指导有限。这表明需要在骨质疏松症指南中进一步关注处方。
