Reduction of polypharmacy by feedback to clinicians

Area of Science:

• Geriatric Medicine
• Clinical Pharmacy
• Health Services Research

Background:

• Polypharmacy is a significant issue in older adults, increasing risks of adverse events and healthcare costs.
• Managing multiple medications in outpatients requires effective interventions to ensure patient safety and optimize treatment.

Purpose of the Study:

• To evaluate the effectiveness of two educational interventions in reducing polypharmacy among outpatients prescribed ten or more medications.
• To compare a simple notification strategy against a more intensive intervention for medication reduction.

Main Methods:

• A randomized controlled trial involving 292 outpatients with polypharmacy at the Denver Veterans Affairs Center.
• Interventions included simple provider notification, intensive notification with chart review and recommendations, and a control group.
• Outcomes were measured by the reduction in the number of active medications at four and six months.

Main Results:

• The simple notification group demonstrated a significant reduction in polypharmacy compared to the control group at four months (p = 0.028).
• No significant difference in medication reduction was observed between the simple and intensive intervention groups (p = 0.189).
• The significant difference in polypharmacy reduction between groups was not sustained by six months.

Conclusions:

• A straightforward educational intervention can effectively reduce polypharmacy in high-risk outpatient populations.
• Intensifying the intervention did not yield superior results in reducing medication burden.
• The sustainability of polypharmacy reduction beyond four months requires further investigation.