THE ROLE OF THE PHARMACIST IN DEPRESCRIBING POTENTIALLY INAPPROPRIATE MEDICATIONS IN THE ELDERLY: A SYSTEMATIC REVIEW

Abstract

Introduction: With the increase in the elderly population, polypharmacy, defined as the simultaneous use of five or more medications, is prevalent, increasing the risks of adverse reactions, drug interactions, falls, and hospitalizations. In this context, deprescribing emerges as a strategy to reduce the use of potentially inappropriate medications and promote greater safety, highlighting the importance of the pharmacist. Objective: To analyze the scientific evidence on the effectiveness of pharmaceutical interventions in the process of deprescribing potentially inappropriate medications in the elderly, identifying the tools used and the main clinical outcomes achieved. Methods: This is a systematic review, conducted according to the PRISMA guidelines. Inclusion criteria were original articles that directly addressed the topic, available in full between 2021 and 2026, including clinical trials and randomized clinical trials. Exclusion criteria were duplicate studies, systematic reviews, isolated case reports, articles with paid access, and publications that, after complete reading, did not meet the objectives of this review. Descriptors related to deprescribing, polypharmacy, elderly, and pharmaceutical care were used, combined using the Boolean operators “AND” and “OR”, in Portuguese and English, in the PubMed, BVS, SciELO, and Cochrane databases. Results: Of the 3,463 articles found, 6 met the inclusion criteria. The studies demonstrated that pharmacist-led interventions significantly reduced the use of potentially inappropriate medications, in addition to decreasing the risk of falls and improving therapeutic safety. Tools such as Beers Criteria, STOPP/START, and electronic decision support systems proved effective in the review process. Conclusions: The pharmacist's role proved essential in promoting the rational use of medications and contributing to safer, more individualized, and effective treatment in the elderly. Multidisciplinary strategies and structured tools strengthen the deprescribing process and reduce the risks associated with polypharmacy.