CAN DEPRESCRIBING GIVE WHAT POLYPHARMACY HAS TAKEN AWAY? FEASIBILITY TRIAL IN RESIDENTIAL AGED CARE

Polypharmacy, with its resulting negative health outcomes, is increasing worldwide alongside our ageing population. In specific, anticholinergic and sedative medicines contribute to the decline in cognitive and physical functioning of older people. The Drug Burden Index (DBI) measures the cumulative daily sedative and anticholinergic load. Our aim was to examine the feasibility of reducing the DBI of older people living in residential aged care facilities (RACFs). Residents aged ≥65 years prescribed one or more anticholinergic or sedative medicine, were recruited from three RACFs in New Zealand. A patient-centred approach was implemented; where a clinically trained pharmacist conducted a resident interview and a comprehensive medicine review for each participant. Deprescribing recommendations were put forward to the residents’ general practitioner (GP). We recruited 37 participants with a mean age of 82.8 ± 8.2. Residents were followed up three months after their GP deprescribed one or more of their medicine(s). A Wilcoxon Signed-Rank test indicated that post DBI test ranks, were statistically significantly less than pre DBI test ranks (p= 0.00016) and post-Cognition Performance Score (CPS) test ranks were statistically significantly less than pre-CPS test ranks (p=0.02). In addition, a one-sided paired t-test showed that potential adverse drug reactions (ADRs) decreased by a mean of 2.92 (p=0.0001). Therefore, the pharmacist’s deprescribing intervention resulted in a statistically significant reduction in both residents’ DBI and potential ADRs; as well as an improvement in residents’ cognition. This supports existing research that deprescribing can reverse negative polypharmacy effects and result in several potential health benefits.