Implementing a medication review and deprescribing intervention for older people...

연구 요약

Implementing a medication review and deprescribing intervention for older people living with frailty and polypharmacy in general practice: a feasibility study.

BJGP open 학술지에 발표된 이 연구는 Radcliffe E, Kandala N, Sach T 외 연구팀이 수행하였습니다.

이 연구는 'Implementing a medication review and deprescribing intervention for older people living with frailty and polypharmacy in general practice: a feasibility study.'에 대한 과학적 분석을 제공합니다.

핵심 내용

BACKGROUND: Polypharmacy in older adults with frailty increases risks of adverse outcomes. Evidence supports proactive structured medication reviews (SMRs) for medicines optimisation, including deprescribing, however challenges exist in general practice. AIM: To test the implementation of a co-designed multidisciplinary SMR intervention (MODIFY) for this high-risk group. DESIGN & SETTING: A non-randomised pre-post feasibility study was conducted across five general practices in England. The multidisciplinary intervention comprised five components including patient and health care professional (HCP) preparation. METHOD: Patients aged ≥75 with moderate-to-severe frailty (eFI >0.25) and ≥5 medications were identified and invited to participate.Primary outcomes were recruitment, retention, and completion of outcome measures. Secondary outcomes included medication-related outcomes, healthcare utilisation, adverse drug reactions, and acceptability to patients and HCPs based on qualitative interviews. RESULTS: Of 479 patients invited, 48 were recruited (10% rate); 47 received the intervention, 43 completed three-month follow-up (92% retention). Medication changes occurred in 87% of participants; 72% had at least one medication stopped and 26% had a dose reduced. The mean number of medications decreased slightly by 0.27 (SD:1.44) without significant change in clinical and patient-reported outcomes (including function, frailty status, treatment burden) and no reported adverse events. Qualitative interviews with 10 patients, 1 carer, and 8 HCPs, indicated high acceptability and perceived value, and suggested improvements.Economic data was well completed. SMRs cost £28.50 per patient. Participants' reported quality of life improved slightly over three months. CONCLUSION: The MODIFY intervention is feasible and acceptable for deprescribing in primary and support progression to a definitive trial.

일반인을 위한 해석

구체적인 실천 사항은 담당 의사 또는 약사와 상담하시기 바랍니다.

실천 사항

• 현재 복용 중인 약물이나 영양제에 대해 궁금한 점이 있다면 담당 의사 또는 약사와 상담하시기 바랍니다
• 약물이나 영양제의 용법·용량을 임의로 변경하지 마세요
• 이상 반응이 나타나면 즉시 전문가에게 문의하세요

의사/약사의 전문적 판단을 대체하지 않습니다 (PMID: 41781269)