Long-term results of a multidisciplinary medication optimization program for older adults including primary care and...

Therapeutic optimization and deprescribing in older adults face multiple barriers, whereas drug-related hospitalization increased from 3.6% to 8.5% between 2006 and 2018. The OPTIMEDOC program aims to optimize older adults' prescriptions through clinical medication review conducted by a multidisciplinary team including clinical pharmacist, geriatrician, and general practitioner (GP). This collaboration between primary care and hospital team aims to enable appropriate and sustainable prescriptions.

This study aimed to assess the implementation of therapeutic optimizations at least 6 months after the intervention. The secondary objective was to document the most frequently deprescribed and newly introduced medications and their long-term implementation rate.

This observational study was conducted in a university hospital, including patients who benefited from the OPTIMEDOC program from April 2022 to April 2024. The primary outcome was the long-term implementation rate of recommendations. The secondary outcome was a description of the optimized drugs according to ATC2 classes.

Among 1580 validated therapeutic recommendations for 143 patients included with an average age of 86.4 years old, 1473 were followed up (93.2%). Of these, 1017 were successfully implemented over 1 year (69.0%). Specifically, 81.8% of deprescriptions, 58.3% of introductions, and 70.5% of modifications were implemented. Although vaccine introductions were the most frequently recommended (n = 222), only 41% were implemented. Regarding deprescribing, psycholeptics, psychoanaleptics, and drugs for acid-related disorders had a long-term implementation rate of over 75%.

These results validate the OPTIMEDOC program as an effective strategy for sustainable therapeutic optimization, especially for deprescribing. Engaging community pharmacists could further enhance the implementation of therapeutic recommendations.