Effect of a patient-centred deprescribing procedure in older multimorbid patients in Swiss primary care - A cluster-randomised clinical trial

BMC Geriatrics
Stefan ZechmannStefan Neuner-Jehle

Abstract

Management of patients with polypharmacy is challenging, and evidence for beneficial effects of deprescribing interventions is mixed. This study aimed to investigate whether a patient-centred deprescribing intervention of PCPs results in a reduction of polypharmacy, without increasing the number of adverse disease events and reducing the quality of life, among their older multimorbid patients. This is a cluster-randomised clinical study among 46 primary care physicians (PCPs) with a 12 months follow-up. We randomised PCPs into an intervention and a control group. They recruited 128 and 206 patients if ≥60 years and taking ≥five drugs for ≥6 months. The intervention consisted of a 2-h training of PCPs, encouraging the use of a validated deprescribing-algorithm including shared-decision-making, in comparison to usual care. The primary outcome was the mean difference in the number of drugs per patient (dpp) between baseline and after 12 months. Additional outcomes focused on patient safety and quality of life (QoL) measures. Three hundred thirty-four patients, mean [SD] age of 76.2 [8.5] years participated. The mean difference in the number of dpp between baseline and after 12 months was 0.379 in the intervention group (8.02 and 7...Continue Reading

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Citations

Mar 26, 2021·Archives of Gerontology and Geriatrics·Liang-Kung Chen
Jul 6, 2021·Journal of General and Family Medicine·Kenya IeSteven M Albert
Jul 27, 2021·Current Epidemiology Reports·Heather E Barry, Carmel M Hughes
Oct 28, 2021·Journal of Gerontological Nursing·Raül Sancho AgredanoNúria Fabrellas

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