Meta-analysisindependent cross-checkabstract checked I-SYS-109 standard review
Reviewing medicines in care homes
Evaluating the impact of medication review and deprescribing on prescribing appropriateness and clinical outcomes in older people residing in long-term care facilities: a systematic review and meta-analysis.
Overview
Carollo M et al.. Age Ageing 2026 · PMID 41967033 · DOI 10.1093/ageing/afag084
Supervised medicine reviews reduced the number of drugs without increasing falls, hospital stays or deaths.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Effect of deprescribing.
- How was the study done?
Meta-analysis.
- How many people, animals or samples were studied?
38 studies.
- What was actually found?
Fewer drugs; no change in hard outcomes.
- How large was the observed effect?
-1.6 drugs at >=12 months.
- What do the results mean in everyday life?
Some medicines can be stopped safely with a doctor.
- What are the study's limitations?
Bias risk.
- What does it say about Elawady's specific claim?
Supports supervised reduction only.
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
Benefit of stopping all drugs.
Scientific in-depth review
1. Full reference
- Authors
- Carollo M et al.
- Journal
- Age Ageing
- Year
- 2026
- Identifier
- PMID 41967033 DOI 10.1093/ageing/afag084
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
One author with industry advisory roles unrelated to topic (PubMed record)
2. Research question
Impact of medication review/deprescribing in older long-term-care residents with polypharmacy
3. Study design and population
- Study design
- Meta-analysis – Systematic review and meta-analysis of experimental studies (22 RCTs, 16 quasi-experimental)
- Population
Older residents of long-term care facilities
- Country
International
- Period
Searches to 27 August 2024
- Sample size
38 studies
- Inclusion and exclusion criteria
Experimental studies
4. Methods and endpoints
- Exposure / intervention
Medication review / deprescribing
- Comparator
Usual care
- Endpoints
Number of drugs, potentially inappropriate medications, falls, hospitalisations, mortality
- Statistical methods
Risk ratios, mean differences; RoB 2, ROBINS-I
5. Actual results
- Results
Number of drugs per patient fell (-0.89 within 12 months; -1.60 at >=12 months) and inappropriate medications fell; no significant effects on falls, hospitalisations or mortality. Risk of bias moderate-high in most studies.
- Absolute risks
not reported
- Authors' conclusion
Medication review improved prescribing appropriateness but did not significantly affect falls, hospitalisations or mortality.
6. Strengths
- Registered (PROSPERO)
- RCTs included
7. Weaknesses
- Heterogeneous
- Risk of bias
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Abstract-level judgement.
9. Assessment of the statistical interpretation
Null clinical outcomes; reductions in drug counts.
10. Relevance to the specific claim
Supports the legitimate kernel that unnecessary medicines can be reduced safely under supervision - but only selectively, not 'zero medicine'.
11. Independent contrary findings
No mortality benefit shown; does not support stopping all medicines.
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Supports supervised deprescribing, not blanket medicine avoidance.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | indirect |
| Reproducibility | unknown |
| Consistency with the overall evidence | mixed |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- The system's life method is 'zero medicine': a life without any medicines at all. – Studies with mixed or unclear results