Affiliation:
1. Department of Clinical Pharmacology Copenhagen University Hospital, Bispebjerg and Frederiksberg Copenhagen Denmark
2. Department of Geriatric and Palliative Medicine Copenhagen University Hospital, Bispebjerg and Frederiksberg Copenhagen Denmark
3. Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
4. Herlev and Gentofte, Center for Clinical Metabolic Research Copenhagen University Hospital Copenhagen Denmark
5. Center for Translational Research Copenhagen University Hospital, Bispebjerg and Frederiksberg Copenhagen Denmark
Abstract
AimsTo provide posthoc analyses of a clinical trial that reported beneficial effects of medication reviews on health‐related quality of life. Specifically, to describe the medication changes with a focus on deprescribing and to explore patient‐ and medication‐related factors that may identify patients most likely to benefit from medication reviews.MethodsPosthoc analyses of data from a pragmatic, nonblinded, randomized clinical trial investigating a medication review intervention (NCT03911934) in 408 geriatric outpatients treated with ≥9 medicines.ResultsIn the medication review group (n = 196), 26% of the medicines prescribed at baseline were discontinued with 82% still being discontinued after 13 months. The most common reason for discontinuation was lack of indication (72% of discontinuations). The medicines most often discontinued in the medication review group compared with usual care included: metoclopramide (11/15 = 73% discontinued vs. 1/12 = 8% in usual care), acetylsalicylic acid (20/48 = 42% vs. 2/47 = 4%), simvastatin (18/48 = 38% vs. 2/58 = 3%), zopiclone (23/59 = 39% vs. 4/54 = 7%), quinine (9/14 = 64% vs. 6/16 = 38%), citalopram (4/18 = 22% vs. 0/20 = 0%) and tramadol (18/37 = 49% vs. 8/30 = 27%). Factors associated with number of deprescribed medicines included: number of prescribed medicines, Drug Burden Index, patient motivation for medicine changes, and prescriptions of metoclopramide, iron preparations, antidepressants other than selective serotonin reuptake inhibitors, nonsteroidal anti‐inflammatory drugs, or drugs for urinary incontinence.ConclusionPhysician‐led medication reviews resulted in persistent deprescribing of medicines in older polypharmacy patients treated with ≥9 medicines. Motivation for having their medicine changed, treatment with more medicines, and a higher burden of sedative and anticholinergic medicines characterized the patients most likely to benefit from physician‐led medication reviews.
Subject
Pharmacology (medical),Pharmacology
Cited by
1 articles.
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