Background Prolonged use of
anticholinergic and
sedative medicines is correlated with worsening cognition and physical function decline.
Deprescribing is a proposed intervention that can help to minimise
polypharmacy whilst potentially improving several health outcomes in older people. Objective This study aimed to examine the feasibility of implementing a
deprescribing intervention that utilises a patient-centred pharmacist-led intervention model; in order to address major
deprescribing challenges such as general practitioner time constraints and lack of accessible
deprescribing guidelines and processes. Setting Three residential care facilities. Methods The intervention involved a New Zealand registered pharmacist utilising peer-reviewed
deprescribing guidelines to recommend targeted
deprescribing of
anticholinergic and
sedative medicines to GPs. Main outcome measure The change in the participants'
Drug Burden Index (
DBI) total and
DBI 'as required' (PRN) was assessed 3 and 6 months after implementing the
deprescribing intervention. Results Seventy percent of potential participants were recruited for the study (n = 46), and 72% of
deprescribing recommendations suggested by the pharmacist were implemented by General Pratitioners (p = 0.01; Fisher's exact test). Ninety-six percent of the residents agreed to the
deprescribing recommendations, emphasising the importance of patient centred approach.
Deprescribing resulted in a significant reduction in participants'
DBI scores by 0.34, number of falls and
adverse drug reactions, 6 months post
deprescribing. Moreover, participants reported lower depression scores and scored lower
frailty scores 6 months after
deprescribing. However, cognition did not improve; nor did participants' reported quality of life. Conclusion This patient-centred
deprescribing approach, demonstrated a high uptake of
deprescribing recommendations and success rate. After 6 months, significant benefits were noted across a range of important health measures including mood,
frailty, falls and reduced adverse reactions. This further supports
deprescribing as a possible imperative to improve health outcomes in older adults.