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A Collaborative Deprescribing Intervention in a Subacute Medical Outpatient Clinic: A Pilot Randomized Controlled Trial

Medication deprescribing is essential to prevent inappropriate medication use in multimorbid patients. However, experience of deprescribing in Danish Subacute Medical Outpatient Clinics (SMOCs) is limited. The objective of our pilot study was to evaluate the feasibility and sustainability of a colla...

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Autores principales: Aharaz, Anissa, Rasmussen, Jens Henning, McNulty, Helle Bach Ølgaard, Cyron, Arne, Fabricius, Pia Keinicke, Bengaard, Anne Kathrine, Sejberg, Hayley Rose Constance, Simonsen, Rikke Rie Løvig, Treldal, Charlotte, Houlind, Morten Baltzer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066016/
https://www.ncbi.nlm.nih.gov/pubmed/33808080
http://dx.doi.org/10.3390/metabo11040204
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author Aharaz, Anissa
Rasmussen, Jens Henning
McNulty, Helle Bach Ølgaard
Cyron, Arne
Fabricius, Pia Keinicke
Bengaard, Anne Kathrine
Sejberg, Hayley Rose Constance
Simonsen, Rikke Rie Løvig
Treldal, Charlotte
Houlind, Morten Baltzer
author_facet Aharaz, Anissa
Rasmussen, Jens Henning
McNulty, Helle Bach Ølgaard
Cyron, Arne
Fabricius, Pia Keinicke
Bengaard, Anne Kathrine
Sejberg, Hayley Rose Constance
Simonsen, Rikke Rie Løvig
Treldal, Charlotte
Houlind, Morten Baltzer
author_sort Aharaz, Anissa
collection PubMed
description Medication deprescribing is essential to prevent inappropriate medication use in multimorbid patients. However, experience of deprescribing in Danish Subacute Medical Outpatient Clinics (SMOCs) is limited. The objective of our pilot study was to evaluate the feasibility and sustainability of a collaborative deprescribing intervention by a pharmacist and a physician to multimorbid patients in a SMOC. A randomized controlled pilot study was conducted, with phone follow-up at 30 and 365+ days. A senior pharmacist performed a systematic deprescribing intervention using the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria, the Danish deprescribing list, and patient interviews. A senior physician received the proposed recommendations and decided which should be implemented. The main outcome was the number of patients having ≥1 medication where deprescribing status was sustained 30 days after inclusion. Out of 76 eligible patients, 72 (95%) were included and 67 (93%) completed the study (57% male; mean age 73 years; mean number of 10 prescribed medications). Nineteen patients (56%) in the intervention group and four (12%) in the control group had ≥1 medication where deprescribing status was sustained 30 days after inclusion (p = 0.015). In total, 37 medications were deprescribed in the intervention group and five in the control group. At 365+ days after inclusion, 97% and 100% of the deprescribed medications were sustained in the intervention and control groups, respectively. The three most frequently deprescribed medication groups were analgesics, cardiovascular, and gastrointestinal medications. In conclusion, a collaborative deprescribing intervention for multimorbid patients was feasible and resulted in sustainable deprescribing of medication in a SMOC.
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spelling pubmed-80660162021-04-25 A Collaborative Deprescribing Intervention in a Subacute Medical Outpatient Clinic: A Pilot Randomized Controlled Trial Aharaz, Anissa Rasmussen, Jens Henning McNulty, Helle Bach Ølgaard Cyron, Arne Fabricius, Pia Keinicke Bengaard, Anne Kathrine Sejberg, Hayley Rose Constance Simonsen, Rikke Rie Løvig Treldal, Charlotte Houlind, Morten Baltzer Metabolites Article Medication deprescribing is essential to prevent inappropriate medication use in multimorbid patients. However, experience of deprescribing in Danish Subacute Medical Outpatient Clinics (SMOCs) is limited. The objective of our pilot study was to evaluate the feasibility and sustainability of a collaborative deprescribing intervention by a pharmacist and a physician to multimorbid patients in a SMOC. A randomized controlled pilot study was conducted, with phone follow-up at 30 and 365+ days. A senior pharmacist performed a systematic deprescribing intervention using the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria, the Danish deprescribing list, and patient interviews. A senior physician received the proposed recommendations and decided which should be implemented. The main outcome was the number of patients having ≥1 medication where deprescribing status was sustained 30 days after inclusion. Out of 76 eligible patients, 72 (95%) were included and 67 (93%) completed the study (57% male; mean age 73 years; mean number of 10 prescribed medications). Nineteen patients (56%) in the intervention group and four (12%) in the control group had ≥1 medication where deprescribing status was sustained 30 days after inclusion (p = 0.015). In total, 37 medications were deprescribed in the intervention group and five in the control group. At 365+ days after inclusion, 97% and 100% of the deprescribed medications were sustained in the intervention and control groups, respectively. The three most frequently deprescribed medication groups were analgesics, cardiovascular, and gastrointestinal medications. In conclusion, a collaborative deprescribing intervention for multimorbid patients was feasible and resulted in sustainable deprescribing of medication in a SMOC. MDPI 2021-03-30 /pmc/articles/PMC8066016/ /pubmed/33808080 http://dx.doi.org/10.3390/metabo11040204 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Aharaz, Anissa
Rasmussen, Jens Henning
McNulty, Helle Bach Ølgaard
Cyron, Arne
Fabricius, Pia Keinicke
Bengaard, Anne Kathrine
Sejberg, Hayley Rose Constance
Simonsen, Rikke Rie Løvig
Treldal, Charlotte
Houlind, Morten Baltzer
A Collaborative Deprescribing Intervention in a Subacute Medical Outpatient Clinic: A Pilot Randomized Controlled Trial
title A Collaborative Deprescribing Intervention in a Subacute Medical Outpatient Clinic: A Pilot Randomized Controlled Trial
title_full A Collaborative Deprescribing Intervention in a Subacute Medical Outpatient Clinic: A Pilot Randomized Controlled Trial
title_fullStr A Collaborative Deprescribing Intervention in a Subacute Medical Outpatient Clinic: A Pilot Randomized Controlled Trial
title_full_unstemmed A Collaborative Deprescribing Intervention in a Subacute Medical Outpatient Clinic: A Pilot Randomized Controlled Trial
title_short A Collaborative Deprescribing Intervention in a Subacute Medical Outpatient Clinic: A Pilot Randomized Controlled Trial
title_sort collaborative deprescribing intervention in a subacute medical outpatient clinic: a pilot randomized controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066016/
https://www.ncbi.nlm.nih.gov/pubmed/33808080
http://dx.doi.org/10.3390/metabo11040204
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