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Title: | Deprescribing for older people living in residential aged care facilities: pharmacist recommendations, doctor acceptance and implementation |
Authors: | Quek, H. W.;Etherton-Beer, C.;Page, A.;McLachlan, A. J.;Lo, S. Y.;Naganathan, V.;Kearney, L.;Hilmer, S. N.;Comans, T.;Mangin, D.;Lindley, Richard I.;Potter, K. |
WSLHD Author: | Lindley, Richard I. |
Issue Date: | 2023 |
Citation: | Archives of Gerontology and Geriatrics 107:104910, 2023 |
Abstract: | BACKGROUND: Deprescribing is an intervention to address the high prevalence of inappropriate polypharmacy in older people living in residential aged care facilities (RACFs). Many deprescribing interventions are complex and involve several stages including initial pharmacist recommendation, subsequent acceptance of the recommendations by a prescriber and the patient, and then actual implementation. OBJECTIVES: This study aimed to investigate pharmacist deprescribing recommendations for residents within RACFs, general practitioner (GP) acceptance, and the actual implementation of the accepted recommendations at 12-month. METHODS: The intervention occurred as part of a randomised controlled trial and comprised a pharmacist-led medication review using an evidence-based algorithm, with the focus on identifying medications to potentially deprescribe. Consent to participate was obtained from residents (or surrogate decision-makers), RACF nursing staff and the resident's GP. Deprescribing recommendations were reviewed by GPs before implementation as part of the intervention and control arms of the trial, although control group participants continued to receive their usual medications in a blinded manner. RESULTS: There were 303 participants enrolled in the study, and 77% (941/1222) of deprescribing recommendations suggested by the pharmacists were accepted by GPs. Of the recommendations accepted by GPs, 74% (692/ 941) were successfully implemented at the end of the follow-up visit at 12 months. The most common reason for deprescribing was because medications were no longer needed (42%, 513/ 1231). CONCLUSION: Pharmacist-led deprescribing recommendations arising from an algorithm-based medication review are acceptable to doctors and can have a significant impact on reducing the number of inappropriate medications consumed by older people in RACFs. |
URI: | https://wslhd.intersearch.com.au/wslhdjspui/handle/1/7189 |
DOI: | https://doi.org/10.1016/j.archger.2022.104910 |
Journal: | Archives of Gerontology and Geriatrics |
Type: | Journal Article |
Study or Trial: | Controlled Study Major Clinical Study |
Department: | Geriatric Medicine |
Facility: | Blacktown Westmead Auburn |
Affiliated Organisations: | Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia School of Allied Health, University of Western Australia, Perth, WA, Australia Western Australia Centre for Health and Aging, School of Medicine, University of Western Australia, Perth, WA, Australia Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation General Hospital, Concord, NSW, Australia Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia Kolling Institute, Faculty of Medicine and Health, Northern Clinical School, The University of Sydney and Royal North Shore Hospital, St Leonards, NSW, Australia Menzies Health Institute Queensland, Griffith University, University Drive Meadowbrook, Brisbane, QLD, Australia Primary Care Research Unit, Department of Public Health and General Practice, Christchurch School of Medicine & Health Sciences, University of Otago, Christchurch, New Zealand Sydney Medical School, University of Sydney, Sydney, NSW, Australia The George Institute for Global Health, Sydney, NSW, Australia Ryman Healthcare, Christchurch, New Zealand |
Keywords: | Deprescribing PIMs Polypharmacy Nursing home Acceptability Interprofessional relations Medication therapy management Medication review |
Appears in Collections: | Blacktown Mount Druitt Hospital |
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