Deprescribing Tools in Primary Care: A Critical Review and the Pivotal Role of the Community Pharmacist.

Abstract

<b>Introduction:</b> Deprescribing is crucial for improving pharmacotherapeutic safety in polymedicated patients, a common profile in community pharmacy. However, a gap exists between the available evidence and real-world clinical practice. <b>Objective:</b> This review aimed to identify and critically analyze validated deprescribing tools, assessing their applicability in the community setting and highlighting the leading role the pharmacist can assume. <b>Material and Methods:</b> A critical narrative review was conducted via a literature search in PubMed/MEDLINE and LILACS, period 2014-2024, using the terms MeSH Deprescribing AND Inappropriate prescription, OR Inappropriate Medicaments. Tools with psychometric and/or clinical validation were included. Two independent reviewers screened studies, and discrepancies were resolved by consensus. <b>Results:</b> Out of 71 screened studies, 23 were included. We identified 5 updated clinical criteria, 9 specific tools for pharmacological groups, and 9 attitudinal questionnaires. Technical maturity in tools is evident, but critical gaps persist: therapeutic fragmentation, absence of Spanish validation for key instruments, and the exclusion of the community pharmacist from many of them. A key finding is the high willingness to deprescribe among patients (87.6%) and caregivers (74.8%). <b>Conclusions:</b> We conclude that the community pharmacist, due to their accessibility and holistic view of medication, is the ideal professional to drive deprescribing.