Avoiding Adverse Drug Withdrawal Events When Stopping Unnecessary Medications According to the STOPPFrail Criteria
OBJECTIVE: To provide clinicians with information about avoiding adverse drug withdrawal events (ADWEs) when discontinuing unnecessary medications as per the STOPPFrail criteria. DATA SOURCES: Searches of MEDLINE (1970-June 2020), the Cochrane Database of Systematic Reviews (through June 2020), Google Scholar (through June 2020). STUDY SELECTiON: Reviews and original studies of ADWEs. DATA EXTRACTiON: Tapering protocols for specific drugs/ classes from randomized controlled deprescribing trials. DATA SYNTHESiS: Six drug classes were identified as being high risk for physiological ADWEs. CONCLUSiON: The occurrence of ADWEs is rare in comparison to adverse drug reactions in older adults. Few drugs/classes have been reported to have physiological ADWEs with abrupt discontinuation. For these we provide information about tapering protocols and symptom monitoring to avoid ADWEs.