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There is a growing number of service users looking to discontinue use of psychiatric medicines. Tapering is the recommended approach for reducing and/or discontinuing the use of psychiatric medicines. This involves gradually reducing the dose over time to minimise the potential for withdrawal symptoms. However, many uncertainties exist regarding the process of reducing and stopping psychiatric medicines. This study will use a James Lind Alliance Priority Setting Partnership to determine the Top 10 list of unanswered questions and uncertainties about reducing and stopping psychiatric medicines. This list will help to guide future research and deliver responsive and strategic allocation of research resources, with a view to ultimately improving the future health and well-being of individuals who are taking psychiatric medicines.

To date, the evidence base for mobile phone applications (‘apps’) and app-based interventions supporting discontinuation of psychotropic use has not been examined. This scoping review aims to examine the content, underpinning evidence base and impact of available mobile phone apps and app-based interventions to support psychotropic tapering. This review will be conducted using the Joanna Briggs Institute guidance and results will be reported using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA-ScR) guideline. Several electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science) will be searched from 2008 onwards. Searches of the major app stores will also be conducted: Apple's App Store (iOS), Google Play Store (Android) and Windows Store (Windows). Following screening, key information will be extracted from the included studies and apps. This scoping review will provide a broad overview of available apps to support psychotropic tapering, including a summary of their content using the BCT Taxonomy. The review findings will guide future research relating to the development, implementation and evaluation of app-based interventions to support the tapering of psychotropic medications

The intervention Complexity Assessment Tool for Systematic Reviews (iCAT_SR) has been developed to facilitate detailed assessments of intervention complexity in systematic reviews.2 This study aimed to assess, using the iCAT_SR, the complexity of interventions aimed at improving appropriate polypharmacy in older people, as reported in studies (n = 20) included in the update of a Cochrane review. Interventions were assessed independently by two authors using the six core iCAT_SR domains: (1) ‘Active intervention components’; (2) ‘Target behaviour/actions’; (3) ‘Target organisational levels/categories’; (4) ‘Degree of tailoring’; (5) ‘Level of skill required by intervention deliverers’; (6) ‘Level of skill required by intervention recipients’.2 Attempts were made to apply the tool’s four optional domains: ‘Interaction between intervention components’; ‘Context/setting’; ‘Recipient/provider factors’; ‘Nature of causal pathway’. Disagreements were resolved by consensus discussion. The findings demonstrate that interventions in this area often comprise multiple components and target behaviours. Intermediate to high level skills were typically required by those delivering and receiving the interventions. A lack of detailed reporting in study reports precluded consistent application of the iCAT_SR’s optional domains. This study provides the first detailed assessment of complexity for interventions aimed at improving appropriate polypharmacy in older people. Further work is needed to determine if application of the iCAT_SR can help to determine whether varying levels of complexity impact on the effectiveness of interventions aimed at improving appropriate polypharmacy in older people.

Additional file 1: Supplementary Table 1. CONSORT checklist.

Additional file 2. Intervention complexity assessments based on the iCAT_SR tool.

Additional file 3: Supplementary Table 3. Delivery of the intervention components.

Additional file 2: Supplementary Table 2. Completeness of outcome data.

Additional file 2.