Deprescribing potentially inappropriate medications in memory clinic patients (DePIMM): A feasibility study.

Abstract

Medication-related problems and inappropriate medication use are prevalent among people attending memory clinics. There have been no deprescribing intervention studies in this setting. To evaluate the feasibility of a pharmacist-led interdisciplinary deprescribing intervention study in a memory clinic. A pre-post-intervention study conducted at an outpatient memory clinic of an Australian tertiary care public hospital. Participants were English-speaking, community-dwelling patients identified as being at risk of a medication-related problem, or their carers. Participants received a medication review in their home from a consultant pharmacist who collaborated with the patient/carer, memory clinic, general practitioner and community pharmacist to develop a plan for optimising medication use. The primary outcome was feasibility, based on i) proportion of memory clinic patients eligible for the study, ii) proportion of eligible patients who consented, and iii) proportion of pharmacist-identified inappropriate/unnecessary medications that were deprescribed (reduced or ceased) at six months. One-third of memory clinic patient/carers were eligible (n=82/238), 61% (n=50/82) consented to participate. The median (IQR) age of participants who received the intervention (n=46) was 80.5 (71.5-85.0) years and median (IQR) number of medications was 11 (8.0-13.3). Pharmacists recommended deprescribing 124 medications, and 53 (42.7%) had been ceased or dose-reduced at six months. It was feasible to recruit study participants and deliver a pharmacist-led interdisciplinary deprescribing intervention in this memory clinic setting. A larger, multi-centre study with longer follow-up is needed to confirm effectiveness and clinical outcomes.