{
  "abstract": "Background and Importance The growing number of patients with multiple comorbidities leads to increased polypharmacy.Deprescribing, defined as the safe and supervised discontinuation of unnecessary medications, is a crucial strategy to mitigate risks, reduce adverse events, and enhance patient safety. However, its proactive implementation in routine outpatient clinical practice, particularly within a teaching hospital, remains a challenge.Aim and Objectives This study aimed to contextualise the deprescribing practices observed in recent literature to refine this strategy and support beneficial pharmaceutical interventions for outpatient clinic patients.Material and Methods An integrative literature review was conducted, including articles published between 2017 and 2022. The research was performed in key digital databases: PubMed, BVS, Embase, Web of Science, and Scopus.Inclusion criteria prioritised articles addressing deprescribing in clinical and/or pharmaceutical practice contexts, with mandatory full-text access.The search employed the descriptors: ‘deprescribing’, ‘outpatient clinics’ and ‘general practice,’ combined with terms such as ‘comorbidities’, ‘polypharmacy’, and ‘adverse events’, utilising Boolean operators (‘AND’/’OR’) across Portuguese, English, and Spanish languages.Results Twenty-three articles were selected. Analysis of the studies revealed that reactive deprescribing, and the occurrence of adverse drug reactions, is the most frequent, with the majority of interventions concentrated among geriatricians and elderly patients.Eight articles, involving 3,417 patients, identified 673 medications as eligible for discontinuation. On average, 67.43 medications were successfully deprescribed, with a low reintroduction rate. The most frequently deprescribed medications included: vitamins and supplements (41%), proton pump inhibitors (31.8%), benzodiazepines and non-steroidal anti-inflammatory drugs (27%), in addition to cardiovascular and neuropsychiatric agents.Overall, deprescribing proved to be successful and well-accepted by patients, with success often associated with the involvement of an interdisciplinary team.In this process, the pharmacist acts as a protagonist in identifying and recommending deprescribing, contributing to the safety and rationality of therapy.Key reported clinical benefits included reduction of adverse events, improved treatment adherence, and patient satisfaction.Conclusion and Relevance The results confirm the relevance and benefits of deprescribing demonstrating that a significant portion of outpatient prescriptions contained potentially unnecessary medications.The evidence obtained provides support for the implementation of safe deprescribing practices, highlighting the essential role of the pharmacist as an intervention agent to optimise treatment and ultimately benefit the patient.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Divisao De Farmacia- Instituto Central- Hospital Das Clinicas Hcfmusp- Faculdade De Medicina- Universidade De Sao Paulo- Sao Paulo- Sp- Brasil, Pharmacy, São Paulo, Brazil"
      ],
      "name": "MC Martins"
    },
    {
      "affiliations": [
        "Divisao De Farmacia- Instituto Central- Hospital Das Clinicas Hcfmusp- Faculdade De Medicina- Universidade De Sao Paulo- Sao Paulo- Sp- Brasil, Pharmacy, São Paulo, Brazil"
      ],
      "name": "CE Chaves"
    },
    {
      "affiliations": [
        "Divisao De Farmacia- Instituto Central- Hospital Das Clinicas Hcfmusp- Faculdade De Medicina- Universidade De Sao Paulo- Sao Paulo- Sp- Brasil, Pharmacy, São Paulo, Brazil"
      ],
      "name": "RM Juliano"
    },
    {
      "affiliations": [
        "Instituto Central- Hospital Das Clinicas Hcfmusp- Faculdade De Medicina- Universidade De Sao Paulo- Sao Paulo- Sp- Brasil, Clínica Medica, São Paulo, Brazil"
      ],
      "name": "MDPT Nunes"
    },
    {
      "affiliations": [
        "Divisao De Farmacia- Instituto Central- Hospital Das Clinicas Hcfmusp- Faculdade De Medicina- Universidade De Sao Paulo- Sao Paulo- Sp- Brasil, Pharmacy, São Paulo, Brazil"
      ],
      "name": "PCM Honório"
    },
    {
      "affiliations": [
        "Divisao De Farmacia- Instituto Central- Hospital Das Clinicas Hcfmusp- Faculdade De Medicina- Universidade De Sao Paulo- Sao Paulo- Sp- Brasil, Pharmacy, São Paulo, Brazil"
      ],
      "name": "BP Vanusa"
    }
  ],
  "title": "6ER-046 Deprescribing medications in the outpatient setting: an integrative review to underpin pharmaceutical practice",
  "uid": "6ee52eb8-765f-580a-866e-aaa00626899c"
}