Aharaz Anissa, Rasmussen Jens Henning, McNulty Helle Bach Ølgaard, Cyron Arne, Fabricius Pia Keinicke, Bengaard Anne Kathrine, Sejberg Hayley Rose Constance, Simonsen Rikke Rie Løvig, Treldal Charlotte, Houlind Morten Baltzer
The Capital Region Pharmacy, 2730 Herlev, Denmark.
Multidisciplinary Outpatient Clinic (Fællesambulatoriet, subakutte patientforløb), Copenhagen University Hospital - Amager and Hvidovre, 2300 Copenhagen, Denmark.
Metabolites. 2021 Mar 30;11(4):204. doi: 10.3390/metabo11040204.
Medication deprescribing is essential to prevent inappropriate medication use in multimorbid patients. However, experience of deprescribing in Danish Subacute Medical Outpatient Clinics (SMOCs) is limited. The objective of our pilot study was to evaluate the feasibility and sustainability of a collaborative deprescribing intervention by a pharmacist and a physician to multimorbid patients in a SMOC. A randomized controlled pilot study was conducted, with phone follow-up at 30 and 365+ days. A senior pharmacist performed a systematic deprescribing intervention using the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, the Danish deprescribing list, and patient interviews. A senior physician received the proposed recommendations and decided which should be implemented. The main outcome was the number of patients having ≥1 medication where deprescribing status was sustained 30 days after inclusion. Out of 76 eligible patients, 72 (95%) were included and 67 (93%) completed the study (57% male; mean age 73 years; mean number of 10 prescribed medications). Nineteen patients (56%) in the intervention group and four (12%) in the control group had ≥1 medication where deprescribing status was sustained 30 days after inclusion ( = 0.015). In total, 37 medications were deprescribed in the intervention group and five in the control group. At 365+ days after inclusion, 97% and 100% of the deprescribed medications were sustained in the intervention and control groups, respectively. The three most frequently deprescribed medication groups were analgesics, cardiovascular, and gastrointestinal medications. In conclusion, a collaborative deprescribing intervention for multimorbid patients was feasible and resulted in sustainable deprescribing of medication in a SMOC.
减药对于预防多病共存患者不恰当用药至关重要。然而，丹麦亚急性医疗门诊（SMOCs）的减药经验有限。我们的试点研究目的是评估药剂师和医生对SMOCs中多病共存患者进行联合减药干预的可行性和可持续性。开展了一项随机对照试点研究，并在30天和365天以上进行电话随访。一名资深药剂师使用老年人潜在不适当处方筛查工具（STOPP）标准、丹麦减药清单以及患者访谈进行系统的减药干预。一名资深医生收到提议的建议并决定应实施哪些建议。主要结局是纳入后30天维持减药状态的有≥1种药物的患者数量。在76名符合条件的患者中，72名（95%）被纳入，67名（93%）完成了研究（57%为男性；平均年龄73岁；平均处方药物数量为10种）。干预组中有19名患者（56%），对照组中有4名患者（12%）在纳入后30天维持减药状态的有≥1种药物（P = 0.015）。干预组总共减药37种，对照组减药5种。在纳入后365天以上，干预组和对照组分别有97%和100%的减药药物维持减药状态。最常被减药的三类药物是镇痛药、心血管药物和胃肠道药物。总之，对多病共存患者进行联合减药干预是可行的，并在SMOCs中实现了药物的可持续减药。
