Project Overview

Polypharmacy, or the concomitant use of 5 or more drugs, is a serious health concern affecting more than half of Canadians aged 65 years and older. Medications can be essential, but each additional one increases the risk of an adverse drug event (ADE). Polypharmacy is the number one identifiable risk factor for ADEs and Canada’s 1.1 million frail older adults are especially at risk. ADEs are responsible for nearly 27,000 hospital admissions annually in Canada and up to 20% of return visits to the hospital within 30 days of discharge. Many ADEs could be preventable or ameliorable through interventions to reduce inappropriate prescribing.

Our intervention used an electronic deprescribing tool called MedSafer in order to automate the process of deprescribing. At the time of hospitalization, the patient’s medications and comorbidities, along with a measure of frailty, were entered into MedSafer, which generated an individualized, prioritized, deprescription plan targeting potentially inappropriate medications (PIMs). The most responsible physician would choose to implement the deprescribing plan after thoughtful consideration and discussion with the patient/caregiver. The plan was also be transmitted to the patient's self-identified primary care physician. This initial study sought to evaluate the impact of MedSafer on reduction of PIMs as compared to usual care. Based on what was learned during this study we will be running an important multi-center Canadian study with a primary endpoint of ADEs.