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Ther Adv Drug Saf. 2011 Apr;2(2):37-43. doi: 10.1177/2042098611400332.

A pilot randomized controlled trial of deprescribing.

Author information

1
WA Centre for Health and Ageing, School of Medicine and Pharmacology and Centre for Medical Research, University of Western Australia, and Department of Geriatric Medicine, Royal Perth Hospital, Level 6 Ainslie House, GPO Box X2213, Perth, WA 6847, Australia.
2
Department of Geriatric Medicine, Royal Perth Hospital, Perth, WA, Australia.
3
Pharmacy Department, Royal Perth Hospital Perth, WA, Australia.
4
School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia.
5
School of Medicine and Pharmacology, University of Western Australia and Department of Internal Medicine, Royal Perth Hospital, Perth, WA, Australia.

Abstract

OBJECTIVE:

Polypharmacy and adverse drug reactions are frequent and important among older people. Few clinical trials have evaluated systematic withdrawal of medications among older people. This small, open, study was conducted to determine the feasibility of a randomized controlled deprescribing trial.

METHODS:

Ten volunteers living in the community (recruited by media advertising) and 25 volunteers living in residential aged-care facilities (RCFs) were randomized to intervention or control groups. The intervention was gradual withdrawal of one target medication. The primary outcome was the number of intervention participants in whom medication withdrawal could be achieved. Other outcomes measures were quality of life, medication adherence, sleep quality, and cognitive impairment.

RESULTS:

Participants were aged 80 ± 11 years and were taking 9 ± 2 medications. Fifteen participants commenced medication withdrawal and all ceased or reduced the dose of their target medication. Two subjects withdrew; one was referred for clinical review, and one participant declined further dose reductions.

CONCLUSIONS:

A randomized controlled trial of deprescribing was acceptable to participants. Recruitment in RCFs is feasible. Definitive trials of deprescribing are required.

KEYWORDS:

ageing; deprescribing; polypharmacy prescriptions; treatment withdrawal

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