Frailty-Informed Deprescribing and Shared Decisions in Older Adults

This clinical review examines frailty-informed deprescribing and shared decisions in older adults. The organizing question is how evidence, prognosis, treatment burden, and patient priorities should jointly guide medication review. Ten related scholarly sources are synthesized through a decision-centered framework spanning problem definition, mechanism, measurement, evaluation, implementation, and governance. The review does not invent experiments, pooled estimates, or unreported quantitative results. It instead evaluates the strength and transferability of the available evidence, with particular attention to using chronological age or medication count as a substitute for individualized benefit-risk assessment. The resulting framework links technical or empirical performance to explicit use conditions and identifies tests that should precede wider adoption in medication optimization for older people with complex needs.

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7. Ibrahim, K., Cox, N. J., Stevenson, J. M., Lim, S., Fraser, S. D. S., & Roberts, H. C. (2021). A systematic review of the evidence for deprescribing interventions among older people living with frailty. BMC Geriatrics, 21(1), 258. https://doi.org/10.1186/s12877-021-02208-8 DOI
8. Kim, D. H., & Rockwood, K. (2024). Frailty in Older Adults. New England Journal of Medicine, 391(6), 538-548. https://doi.org/10.1056/nejmra2301292 DOI
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