Abstract：
BACKGROUND: Quality of life (QoL) is an important outcome to capture in clinical trials evaluating deprescribing interventions.
OBJECTIVE: We aimed to conduct a scoping review to examine how QoL has been measured in deprescribing trials among older people and identify potentially relevant QoL scales, to better inform QoL measurement in future deprescribing trials.
METHODS: We searched MEDLINE, Embase, PsycINFO, the Cochrane Central Register of Controlled Trials, Google Scholar, Epistemonikos, ClinicalTrials.gov, and reference lists of eligible studies (from inception to October 2023). We included randomized and non-randomized comparative studies with a control group that evaluated deprescribing and polypharmacy reduction interventions in people ≥ 65 years of age and measured QoL as an outcome. We also included studies describing the development and validation of QoL scales related to deprescribing, polypharmacy, or medication burden in adults ≥ 18 years of age. Two independent reviewers screened titles and abstracts, then full texts. Two independent reviewers extracted data from 25% of eligible studies in order to verify agreement, then a single reviewer extracted data from the remaining studies, which a second reviewer cross-checked. We critically appraised scales based on the COSMIN checklist.
RESULTS: We retrieved 7290 articles, of which 52 were eligible for inclusion, including 44 deprescribing trials and eight scale development studies. From these studies, we found 21 scales that have been used in the context of deprescribing/polypharmacy (12 generic scales used in clinical trials and nine medication-specific scales). Variations of the generic EQ-5D were the most used scales. The measurement properties of scales for capturing changes in QoL from deprescribing were uncertain. Medication-specific QoL scales have not been employed in deprescribing clinical trials and thus, their performance in this context is also not clear.
CONCLUSIONS: Several existing QoL scales have been applied to the context of deprescribing/polypharmacy clinical trials, and new scales specific to the problem have been proposed. If deprescribing does impact QoL, our findings suggest it is uncertain whether existing QoL scales can practically and reliably capture such a change or whether any scale is best. However, this review compares various aspects of the scales that researchers and clinicians can consider in decisions about measuring QoL in deprescribing trials, and in planning future research.
BACKGROUND: Open Science Framework: osf.io/aez6w.
OBJECTIVE: We aimed to conduct a scoping review to examine how QoL has been measured in deprescribing trials among older people and identify potentially relevant QoL scales, to better inform QoL measurement in future deprescribing trials.
METHODS: We searched MEDLINE, Embase, PsycINFO, the Cochrane Central Register of Controlled Trials, Google Scholar, Epistemonikos, ClinicalTrials.gov, and reference lists of eligible studies (from inception to October 2023). We included randomized and non-randomized comparative studies with a control group that evaluated deprescribing and polypharmacy reduction interventions in people ≥ 65 years of age and measured QoL as an outcome. We also included studies describing the development and validation of QoL scales related to deprescribing, polypharmacy, or medication burden in adults ≥ 18 years of age. Two independent reviewers screened titles and abstracts, then full texts. Two independent reviewers extracted data from 25% of eligible studies in order to verify agreement, then a single reviewer extracted data from the remaining studies, which a second reviewer cross-checked. We critically appraised scales based on the COSMIN checklist.
RESULTS: We retrieved 7290 articles, of which 52 were eligible for inclusion, including 44 deprescribing trials and eight scale development studies. From these studies, we found 21 scales that have been used in the context of deprescribing/polypharmacy (12 generic scales used in clinical trials and nine medication-specific scales). Variations of the generic EQ-5D were the most used scales. The measurement properties of scales for capturing changes in QoL from deprescribing were uncertain. Medication-specific QoL scales have not been employed in deprescribing clinical trials and thus, their performance in this context is also not clear.
CONCLUSIONS: Several existing QoL scales have been applied to the context of deprescribing/polypharmacy clinical trials, and new scales specific to the problem have been proposed. If deprescribing does impact QoL, our findings suggest it is uncertain whether existing QoL scales can practically and reliably capture such a change or whether any scale is best. However, this review compares various aspects of the scales that researchers and clinicians can consider in decisions about measuring QoL in deprescribing trials, and in planning future research.
BACKGROUND: Open Science Framework: osf.io/aez6w.
摘要：
背景：生活质量（QoL）是临床试验评估取消处方干预措施的重要结果。
目的：我们旨在进行范围审查，以检查如何在老年人的去处方试验中测量QoL，并确定潜在相关的QoL量表，在未来的去处方试验中更好地告知QoL测量。
方法：我们搜索了MEDLINE，Embase,PsycINFO,Cochrane中央受控试验登记册,谷歌学者，认识论，ClinicalTrials.gov,和合格研究的参考清单（从开始到2023年10月）。我们纳入了随机和非随机比较研究，对照组评估了65岁以上人群的非处方和多药方减少干预措施，并测量了QoL作为结果。我们还包括描述与开处方相关的QoL量表的开发和验证的研究，多药，或成人≥18岁的药物负担。两名独立审稿人筛选了标题和摘要，然后全文。两名独立审稿人从25%的符合条件的研究中提取数据，以验证协议，然后，一个审查者从剩余的研究中提取数据，第二个审阅者进行了交叉检查。我们根据COSMIN检查表对量表进行了严格评估。
结果：我们检索了7290篇文章，其中52人有资格入选，包括44项开药试验和8项量表开发研究。从这些研究中,我们发现21种量表已用于非处方/多药房治疗(12种通用量表用于临床试验,9种药物特异性量表).通用EQ-5D的变体是最常用的量表。用于捕获因开药而导致的QoL变化的量表的测量特性是不确定的。药物特异性QoL量表尚未用于取消处方的临床试验，因此，他们在这方面的表现也不清楚。
结论：几种现有的QoL量表已应用于去处方/多药物临床试验的背景，并提出了针对该问题的新尺度。如果取消处方确实影响QoL，我们的研究结果表明,目前尚不确定现有的QoL量表是否能实际可靠地反映这种变化,或者任何量表是否最好.然而,这篇综述比较了研究人员和临床医生在决定取消处方试验中测量QoL时可以考虑的量表的各个方面，并规划未来的研究。
背景：开放科学框架：osf.io/aez6w。
目的：我们旨在进行范围审查，以检查如何在老年人的去处方试验中测量QoL，并确定潜在相关的QoL量表，在未来的去处方试验中更好地告知QoL测量。
方法：我们搜索了MEDLINE，Embase,PsycINFO,Cochrane中央受控试验登记册,谷歌学者，认识论，ClinicalTrials.gov,和合格研究的参考清单（从开始到2023年10月）。我们纳入了随机和非随机比较研究，对照组评估了65岁以上人群的非处方和多药方减少干预措施，并测量了QoL作为结果。我们还包括描述与开处方相关的QoL量表的开发和验证的研究，多药，或成人≥18岁的药物负担。两名独立审稿人筛选了标题和摘要，然后全文。两名独立审稿人从25%的符合条件的研究中提取数据，以验证协议，然后，一个审查者从剩余的研究中提取数据，第二个审阅者进行了交叉检查。我们根据COSMIN检查表对量表进行了严格评估。
结果：我们检索了7290篇文章，其中52人有资格入选，包括44项开药试验和8项量表开发研究。从这些研究中,我们发现21种量表已用于非处方/多药房治疗(12种通用量表用于临床试验,9种药物特异性量表).通用EQ-5D的变体是最常用的量表。用于捕获因开药而导致的QoL变化的量表的测量特性是不确定的。药物特异性QoL量表尚未用于取消处方的临床试验，因此，他们在这方面的表现也不清楚。
结论：几种现有的QoL量表已应用于去处方/多药物临床试验的背景，并提出了针对该问题的新尺度。如果取消处方确实影响QoL，我们的研究结果表明,目前尚不确定现有的QoL量表是否能实际可靠地反映这种变化,或者任何量表是否最好.然而,这篇综述比较了研究人员和临床医生在决定取消处方试验中测量QoL时可以考虑的量表的各个方面，并规划未来的研究。
背景：开放科学框架：osf.io/aez6w。
