Pharmacist-led educational intervention decreases inappropriate medication prescriptions in older adults
A pharmacist-led educational intervention for older adults led to greater discontinuation of prescriptions for inappropriate medication after 6 months, compared with usual care, according to new research.
A pharmacist-led educational intervention for older adults led to greater discontinuation of prescriptions for inappropriate medication after 6 months, compared with usual care, according to new research. The cluster randomized D-PRESCRIBE trial involved nearly 500 older adults who were prescribed one of four Beers Criteria medications—sedative-hypnotics, first-generation antihistamines, glyburide, or NSAIDs—and recruited from 69 community pharmacies in Quebec. Randomization occurred at the pharmacy level, with 34 pharmacies and 248 patients in the intervention group and 35 pharmacies and 241 patients in the usual care group. In the intervention group, pharmacists were encouraged to send patients an educational deprescribing brochure along with sending their doctors an evidence-based pharmaceutical opinion to recommend deprescribing. After 6 months, 43% of the intervention patients and 12% of the control patients no longer filled prescriptions for inappropriate medication. More specifically, discontinuation of inappropriate medication occurred in 43.2% of intervention sedative-hypnotic drug users and 9.0% of control sedative-hypnotic drug users; 30.6% and 13.8%, respectively, of glyburide users; and 57.6% and 21.7%, respectively, of NSAID users. In the antihistamine class, analysis was not possible due to the small sample size. There were no adverse events requiring hospitalization; however, 38% of 77 patients who tried to taper sedative-hypnotic drugs experienced symptoms of withdrawal. "The generalizability of these findings to other settings requires further research," the authors conclude.