BACKGROUND our aim was to assess the effectiveness of medication review and deprescribing interventions as a single intervention in falls prevention. METHODS DESIGN systematic review and meta-analysis. DATA SOURCES Medline, Embase, Cochrane CENTRAL, PsycINFO until 28 March 2022. ELIGIBILITY CRITERIA randomised controlled trials of older participants comparing any medication review or deprescribing intervention with usual care and reporting falls as an outcome. STUDY RECORDS title/abstract and full-text screening by two reviewers. RISK OF BIAS Cochrane Collaboration revised tool. DATA SYNTHESIS results reported separately for different settings and sufficiently comparable studies meta-analysed. RESULTS forty-nine heterogeneous studies were included. COMMUNITY meta-analyses of medication reviews resulted in a risk ratio (RR) of 1.05 (95% confidence interval, 0.85-1.29, I2 = 0%, 3 studies(s)) for number of fallers, in an RR = 0.95 (0.70-1.27, I2 = 37%, 3 s) for number of injurious fallers and in a rate ratio (RaR) of 0.89 (0.69-1.14, I2 = 0%, 2 s) for injurious falls. HOSPITAL meta-analyses assessing medication reviews resulted in an RR = 0.97 (0.74-1.28, I2 = 15%, 2 s) and in an RR = 0.50 (0.07-3.50, I2 = 72% %, 2 s) for number of fallers after and during admission, respectively. LONG-TERM CARE meta-analyses investigating medication reviews or deprescribing plans resulted in an RR = 0.86 (0.72-1.02, I2 = 0%, 5 s) for number of fallers and in an RaR = 0.93 (0.64-1.35, I2 = 92%, 7 s) for number of falls. CONCLUSIONS the heterogeneity of the interventions precluded us to estimate the exact effect of medication review and deprescribing as a single intervention. For future studies, more comparability is warranted. These interventions should not be implemented as a stand-alone strategy in falls prevention but included in multimodal strategies due to the multifactorial nature of falls.PROSPERO registration number: CRD42020218231.

中文翻译：

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药物审查和取消处方作为跌倒预防的单一干预措施：系统审查和荟萃分析。

背景我们的目的是评估药物审查和取消处方干预措施作为预防跌倒的单一干预措施的有效性。方法设计系统评价和荟萃分析。数据来源 Medline、Embase、Cochrane CENTRAL、PsycINFO 截至 2022 年 3 月 28 日。 资格标准 对老年参与者进行随机对照试验，将任何药物审查或取消处方干预与常规护理进行比较，并报告跌倒结果。研究记录 标题/摘要和全文由两位审稿人筛选。偏见风险 Cochrane Collaboration 修订工具。数据综合结果分别报告了不同环境和充分可比研究的荟萃分析。结果 纳入了四十九项异质性研究。社区药物评论荟萃分析得出跌倒人数的风险比 (RR) 为 1.05（95% 置信区间，0.85-1.29，I2 = 0%，3 项研究），RR = 0.95 (0.70) -1.27，I2 = 37%，3 秒）表示受伤跌倒者的数量，受伤率比率 (RaR) 为 0.89（0.69-1.14，I2 = 0%，2 秒）。评估药物审查的医院荟萃分析得出跌倒人数的 RR = 0.97 (0.74-1.28, I2 = 15%, 2 s) 和 RR = 0.50 (0.07-3.50, I2 = 72% %, 2 s)分别是入院后和入院期间。调查药物审查或取消处方计划的长期护理荟萃分析得出，跌倒人数的 RR = 0.86（0.72-1.02，I2 = 0%，5 秒），RaR = 0.93（0.64-1.35，I2 = 92） %, 7 s) 代表跌倒次数。结论 干预措施的异质性使我们无法估计药物审查和取消处方作为单一干预措施的确切效果。对于未来的研究，需要更多的可比性。由于跌倒的多因素性质，这些干预措施不应作为跌倒预防的独立策略实施，而应包含在多模式策略中。PROSPERO 注册号：CRD42020218231。