Deprescribing in older patients with hyperpolypharmacy: a cluster-randomised trial in primary care.
Background Polypharmacy increases the risk of adverse drug events and potentially preventable hospital admissions. Deprescribing may reduce medication-related harm, and a clinical medication review (CMR) provides an opportunity to support this. Objective To investigate the effect of a deprescribing-...
| Publicado en: | Age & Ageing Vol. 55; no. 7; pp. 1 - 13 |
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| Autores principales: | , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Jul2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195867364&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195867364 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jul2026 vid: 55 iid: 7 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195867364 10.1093/ageing/afag209 ppf: 1 ppct: 12 formats: tig: atl: Deprescribing in older patients with hyperpolypharmacy: a cluster-randomised trial in primary care. aug: au: Baas, Gert Heringa, Mette Verdoorn, Sanne Kwint, Henk-Frans Badawy, Eman Gussekloo, Jacobijn Burgers, Jako Denig, Petra Bouvy, Marcel L affil: SIR Institute for Pharmacy Practice and Policy, Leiden, ZH, The NetherlandsDepartment of Pharmaceutical Sciences, Utrecht University, Utrecht 125, The Netherlands SIR Institute for Pharmacy Practice and Policy, Leiden, ZH, The Netherlands Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands Department of Family Medicine, Maastricht University, Maastricht, LI, The NetherlandsDutch College of General Practitioners (NHG), Utrecht, The Netherlands Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center Groningen, PO Box 30001 EB71, Groningen 9700RB, The Netherlands Department of Pharmaceutical Sciences, Utrecht University, Utrecht 125, The Netherlands su: Patient care Randomized controlled trials Research funding Statistical sampling Questionnaires Polypharmacy Deprescribing Medication error prevention Descriptive statistics Analysis of covariance Cluster sampling Data analysis software Confidence intervals sug: subj: Patient care Randomized controlled trials Marketing Research and Public Opinion Polling Research funding Statistical sampling Questionnaires Polypharmacy Deprescribing Medication error prevention Descriptive statistics Analysis of covariance Cluster sampling Data analysis software Confidence intervals keyword: (hyper)polypharmacy aged cardiac mri copyrightHolder:British Geriatrics Society copyrightYear:2026 deprescribing https://dx.doi.org/10.1093/ageing/afag209 inLanguage:en major depressive disorder medication review older people polypharmacy publisher:Oxford University Press randomised controlled trial randomization sameAs:https://pubmed.ncbi.nlm.nih.gov/42472621/ (hyper)polypharmacy aged cardiac mri copyrightHolder:British Geriatrics Society copyrightYear:2026 deprescribing https://dx.doi.org/10.1093/ageing/afag209 inLanguage:en major depressive disorder medication review older people polypharmacy publisher:Oxford University Press randomised controlled trial randomization sameAs:https://pubmed.ncbi.nlm.nih.gov/42472621/ ab: Background Polypharmacy increases the risk of adverse drug events and potentially preventable hospital admissions. Deprescribing may reduce medication-related harm, and a clinical medication review (CMR) provides an opportunity to support this. Objective To investigate the effect of a deprescribing-focused CMR by trained pharmacists on the number of reduced and stopped medications among patients aged ≥75 years with hyperpolypharmacy using multidose-drug-dispensing (MDD)-systems. Methods In this cluster-randomised controlled trial, pharmacists were trained to perform a deprescribing-focused CMR, while control pharmacies provided usual care. Eligible patients were aged ≥75 years, had hyperpolypharmacy and used MDD. Dispensing data were used to determine the number of reduced and stopped medications per patient after 6 months (primary outcome). Secondary outcomes were: total number of medications, health problems and quality-of-life (EQ-5D-5L, EQ-VAS). A generalised linear mixed model was used for the primary outcome. Results A total of 318 patients from 58 pharmacies were enrolled (155 intervention, 163 control). At 6 months, patients in the intervention group had significantly more medications deprescribed than those in the control group (mean 2.5 vs. 1.7 per patient; mean difference 0.79, 95% CI 0.29–1.28; P = .002). There was no significant between-group difference in the total number of medications at 6 months (intervention −0.30 vs. control +0.12; P = .108). No significant differences were observed in health problems or quality-of-life. Conclusion Deprescribing-focused CMRs by trained pharmacists successfully increased reduction and stopping of medications in older patients with hyperpolypharmacy using MDD-systems, while no changes in health problems or health-related quality of life could be observed over 6 months. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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