OBJECTIVE To determine whether advised changes as a result of structured medication reviews in psychogeriatnc patients were implemented and implemented changes were maintained. DESIGN We performed a prospective cohort study in three nursing homes in The Netherlands. METHODS After admission, newly admitted psychogeriatnc residents were subjected to a structured medication review - performed by a pharmacist and physician - resulting in a treatment plan, which was approved by the patient's legal representative and effectuated. Main outcome measures were the percentage of advised changes approved |= approval ratel and the percentage of implemented medication changes still present 90 days after approval != 90-day implementation rate). RESULTS A total of 45 patients were included who used a total number of 333 drugs Imean ± SD = 7.4 ± 3.3 drugs). Changes were advised for 159 medications used by 42 patients. Of these changes 150 were approved (approval rate = 94.3%). Finally, 105 were implemented and 89 were still implemented after 90 days (90-day implementation rate = 84.8%). Overall, 59.7% of the advised changes concerned deprescribing, 22.6% concerned an adjustment of a drug (dose, pharmaceutical form, administration time, frequency of dosing or a combination) and 11.9% concerned starting a drug. The proportion of advised changes implemented was similar for symptom-modifying and risk-modifying drugs, namely, almost 85%. Overall, 55.3% of the recommended changes to deprescribe or reduce dose concerned 10 drug groups. CONCLUSION Medication could be successfully deprescribed from psychogeriatnc patients after structured medication reviews, performed by pharmacists and nursing home physicians. More than 50% of the advised changes to deprescribe or reduce dose involved 10 drug groups, which raises the question whether the structured medication review can be performed more efficiently by focusing on the most common problems.
|Translated title of the contribution||Deprescribing in newly admitted psychogeriatnc nursing facility patients|
|Number of pages||6|
|Publication status||Published - 1 Jan 2019|