LESS-PHARMA Study: Identifying and Deprescribing Potentially Inappropriate Medication in the Elderly Population with Excessive Polypharmacy in Primary Care

Xisco Reus (), Maria Lluisa Sastre, Alfonso Leiva, Belén Sánchez, Cristina García-Serra, Ignatios Ioakeim-Skoufa and Caterina Vicens
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Xisco Reus: Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain
Maria Lluisa Sastre: Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain
Alfonso Leiva: Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Spain
Belén Sánchez: Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain
Cristina García-Serra: Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain
Ignatios Ioakeim-Skoufa: Department of Drug Statistics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, 0213 Oslo, Norway
Caterina Vicens: Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain

IJERPH, 2022, vol. 19, issue 20, 1-10

Abstract: Potentially inappropriate medication (PIM) increases adverse drug reactions and mortality, especially in excessively polymedicated patients. General practitioners are often in charge of this process. Some tools have been created to support them in this matter. This study aimed to measure the amount of potentially inappropriate medication among excessively polymedicated patients using several supporting tools and assess the feasibility of these tools in primary care. Several explicit deprescribing criteria were used to identify potentially inappropriate medications. The level of agreement between all the criteria and the acceptance by the general practitioner (GP) was also measured. We analysed whether the drugs proposed for deprescribing were eventually withdrawn after twelve months. The total number of drugs prescribed was 2038. Six hundred and forty-nine drugs (31.8%) were considered potentially inappropriate by at least one of the tools. GPs agreed with the tools in 56.7% of the cases. In a 12-month period, 109 drugs, representing 29.6% of the drugs that GPs agreed to deprescribe, were withdrawn. Elderly excessively polymedicated patients accumulated a great number of PIMs. The use of deprescribing supporting tools, such as explicit criteria, is feasible in primary care, and these tools are well accepted by the GPs. However, eventual withdrawal was carried out in less than half of the cases.

Keywords: potentially inappropriate medication; polypharmacy; deprescribing; elderly (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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