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Multidisciplinary Team Delivered Deprescribing Intervention for Patients Receiving Maintenance Hemodialysis: A Pilot
Amani Zidan1, Abdullah Hamad2, Rania Ibrahim2
1QU-Health, Qatar University, Doha, Qatar.
Clinical Therapeutics
|March 31, 2026
Summary
A deprescribing intervention for hemodialysis patients reduced potentially inappropriate medications (PIMs). This multidisciplinary approach was feasible and safe, showing promise for improving care in chronic kidney disease (CKD).
Area of Science:
- Nephrology
- Clinical Pharmacy
- Geriatrics
Background:
- Polypharmacy is common in chronic kidney disease (CKD) patients.
- Deprescribing interventions can potentially reduce medication-related harm.
- Hemodialysis (HD) patients represent a vulnerable population with high medication burden.
Purpose of the Study:
- To assess the feasibility and safety of a multidisciplinary deprescribing intervention for HD patients.
- To evaluate the preliminary effectiveness of this intervention in reducing potentially inappropriate medications (PIMs).
Main Methods:
- A pilot randomized controlled trial (RCT) involving adult HD patients.
- Participants were randomized to an intervention (structured deprescribing program) or control group.
- Feasibility, safety, PIMs, pill burden, and quality of life were assessed over six months.
Main Results:
- The intervention was feasible and safe, with no serious adverse events.
- The intervention group had significantly fewer PIMs compared to the control group at six months (RR = 4.03).
- Successful implementation of deprescribing plans was high (85.1%), with proton pump inhibitors and antihypertensives most commonly deprescribed.
Conclusions:
- A multidisciplinary deprescribing intervention is feasible, safe, and preliminarily effective in reducing PIMs in HD patients.
- The findings support the need for a larger definitive RCT to confirm effectiveness.
- This intervention holds potential for optimizing medication management in CKD patients.
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