Abstract：
BACKGROUND: Deprescribing (medication dose reduction or cessation) is an integral component of appropriate prescribing. The extent to which deprescribing recommendations are included in clinical practice guidelines is unclear. This scoping review aimed to identify guidelines that contain deprescribing recommendations, qualitatively explore the content and format of deprescribing recommendations and estimate the proportion of guidelines that contain deprescribing recommendations.
METHODS: Bibliographic databases and Google were searched for guidelines published in English from January 2012 to November 2022. Guideline registries were searched from January 2017 to February 2023. Two reviewers independently screened records from databases and Google for guidelines containing one or more deprescribing recommendations. A 10% sample of the guideline registries was screened to identify eligible guidelines and estimate the proportion of guidelines containing a deprescribing recommendation. Guideline and recommendation characteristics were extracted and language features of deprescribing recommendations including content, form, complexity and readability were examined using a conventional content analysis and the SHeLL Health Literacy Editor tool.
RESULTS: 80 guidelines containing 316 deprescribing recommendations were included. Deprescribing recommendations had substantial variability in their format and terminology. Most guidelines contained recommendations regarding for who (75%, n=60), what (99%, n=89) and when or why (91%, n=73) to deprescribe, however, fewer guidelines (58%, n=46) contained detailed guidance on how to deprescribe. Approximately 29% of guidelines identified from the registries sample (n=14/49) contained one or more deprescribing recommendations.
CONCLUSIONS: Deprescribing recommendations are increasingly being incorporated into guidelines, however, many guidelines do not contain clear and actionable recommendations on how to deprescribe which may limit effective implementation in clinical practice. A co-designed template or best practice guide, containing information on aspects of deprescribing recommendations that are essential or preferred by end-users should be developed and employed.
BACKGROUND: osf.io/fbex4.
METHODS: Bibliographic databases and Google were searched for guidelines published in English from January 2012 to November 2022. Guideline registries were searched from January 2017 to February 2023. Two reviewers independently screened records from databases and Google for guidelines containing one or more deprescribing recommendations. A 10% sample of the guideline registries was screened to identify eligible guidelines and estimate the proportion of guidelines containing a deprescribing recommendation. Guideline and recommendation characteristics were extracted and language features of deprescribing recommendations including content, form, complexity and readability were examined using a conventional content analysis and the SHeLL Health Literacy Editor tool.
RESULTS: 80 guidelines containing 316 deprescribing recommendations were included. Deprescribing recommendations had substantial variability in their format and terminology. Most guidelines contained recommendations regarding for who (75%, n=60), what (99%, n=89) and when or why (91%, n=73) to deprescribe, however, fewer guidelines (58%, n=46) contained detailed guidance on how to deprescribe. Approximately 29% of guidelines identified from the registries sample (n=14/49) contained one or more deprescribing recommendations.
CONCLUSIONS: Deprescribing recommendations are increasingly being incorporated into guidelines, however, many guidelines do not contain clear and actionable recommendations on how to deprescribe which may limit effective implementation in clinical practice. A co-designed template or best practice guide, containing information on aspects of deprescribing recommendations that are essential or preferred by end-users should be developed and employed.
BACKGROUND: osf.io/fbex4.
摘要：
背景：取消处方（药物剂量减少或停止）是适当处方的组成部分。在何种程度上取消处方的建议被纳入临床实践指南尚不清楚。这项范围审查旨在确定包含非处方性建议的指南，定性探索非处方性建议的内容和格式，并估计包含非处方性建议的指南比例。
方法：检索2012年1月至2022年11月以英文发布的指南。从2017年1月至2023年2月检索了指南登记册。两名审稿人独立地从数据库和Google中筛选记录，以获取包含一项或多项取消处方建议的指南。筛选了10％的指南注册样本，以确定合格的指南并估计包含无效建议的指南比例。提取了指南和推荐特征，以及取消处方推荐的语言特征，包括内容，形式,使用传统的内容分析和SHELL健康素养编辑器工具检查了复杂性和可读性。
结果：纳入了80份指南，其中包含316项脱处方建议。无效的建议在格式和术语上有很大的差异。大多数指南包含关于谁的建议(75%，n=60),什么（99%，n=89)以及何时或为何(91%，n=73)取消处方，然而,指南较少(58%，n=46）包含有关如何取消处方的详细指南。从注册样本（n=14/49）中确定的指南中约有29％包含一项或多项无效建议。
结论：取消处方的建议越来越多地被纳入指南，然而,许多指南不包含关于如何取消处方的明确和可操作的建议,这可能会限制在临床实践中的有效实施.共同设计的模板或最佳实践指南，应开发和采用包含有关最终用户必不可少或首选的取消处方建议方面的信息。
背景：osf.io/fbex4.
方法：检索2012年1月至2022年11月以英文发布的指南。从2017年1月至2023年2月检索了指南登记册。两名审稿人独立地从数据库和Google中筛选记录，以获取包含一项或多项取消处方建议的指南。筛选了10％的指南注册样本，以确定合格的指南并估计包含无效建议的指南比例。提取了指南和推荐特征，以及取消处方推荐的语言特征，包括内容，形式,使用传统的内容分析和SHELL健康素养编辑器工具检查了复杂性和可读性。
结果：纳入了80份指南，其中包含316项脱处方建议。无效的建议在格式和术语上有很大的差异。大多数指南包含关于谁的建议(75%，n=60),什么（99%，n=89)以及何时或为何(91%，n=73)取消处方，然而,指南较少(58%，n=46）包含有关如何取消处方的详细指南。从注册样本（n=14/49）中确定的指南中约有29％包含一项或多项无效建议。
结论：取消处方的建议越来越多地被纳入指南，然而,许多指南不包含关于如何取消处方的明确和可操作的建议,这可能会限制在临床实践中的有效实施.共同设计的模板或最佳实践指南，应开发和采用包含有关最终用户必不可少或首选的取消处方建议方面的信息。
背景：osf.io/fbex4.
