Visser Anne G R, Schols Jos M G A, Prevoo Mathieu A L M, Janknegt Rob, Winkens Bjorn
Zuyderland Elderly Care, Sittard, The Netherlands.
Department Health Services Research and Family Medicine, Maastricht University, Maastricht, The Netherlands.
Gerontol Geriatr Med. 2021 Oct 24;7:23337214211050807. doi: 10.1177/23337214211050807. eCollection 2021 Jan-Dec.
Polypharmacy is common in the frail nursing home population and associated with an increased risk of adverse events, unplanned hospitalizations, and increased all-cause mortality. Deprescribing using a deprescribing algorithm might reduce unnecessary polypharmacy. This exploratory study was performed to determine the effect of this implicit deprescribing algorithm in deprescribing statins and proton pump inhibitors (PPIs) in nursing home residents.
Multicenter, longitudinal, single-arm exploratory study. All participants received the same deprescribing intervention to identify and deprescribe potentially inappropriate statins and/or PPIs. Residents across 10 nursing homes in the Netherlands were included if they used a statin and/or PPI. Residents in hospices or short-stay wards were excluded. The intervention involved a deprescribing algorithm in which nursing home physicians identified and, if possible, deprescribed potentially inappropriate statins and/or PPIs.
Sixty-seven residents participated in the study. At 3 months, deprescribing was successful in 52% of the residents. Six months after the intervention, all these residents still had their medication sustainably deprescribed.
Based on this study, deprescribing statins and PPIs using an implicit deprescribing algorithm is possible in a considerable number of nursing home residents.
多重用药在体弱的养老院人群中很常见,且与不良事件、非计划住院及全因死亡率增加相关。使用减药算法进行减药可能会减少不必要的多重用药。本探索性研究旨在确定这种隐性减药算法对养老院居民停用他汀类药物和质子泵抑制剂(PPIs)的效果。
多中心、纵向、单臂探索性研究。所有参与者均接受相同的减药干预,以识别并停用潜在不适当的他汀类药物和/或PPIs。荷兰10家养老院中使用他汀类药物和/或PPIs的居民被纳入研究。临终关怀机构或短期病房的居民被排除。干预措施包括一种减药算法,养老院医生据此识别并尽可能停用潜在不适当的他汀类药物和/或PPIs。
67名居民参与了该研究。3个月时,52%的居民减药成功。干预6个月后,所有这些居民的药物仍持续停用。
基于本研究,相当一部分养老院居民使用隐性减药算法停用他汀类药物和PPIs是可行的。