A Collaborative Medication Review Including Deprescribing for Older Patients in an Emergency Department: A Longitudinal Feasibility Study
Open accessAbstract
Medication review for older patients with polypharmacy in the emergency department (ED) is crucial to prevent inappropriate prescribing. Our objective was to assess the feasibility of a collaborative medication review in older medical patients (≥65 years) using polypharmacy (≥5 long-term medications). A pharmacist performed the medication review using the tools: Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria, a drug–drug interaction database (SFINX), and Renbase® (renal dosing database). A geriatrician received the medication review and decided which recommendations should be implemented. The outcomes were: differences in Medication Appropriateness Index (MAI) and Assessment of Underutilization Index (AOU) scores between admission and 30 days after discharge and the percentage of patients for which the intervention was completed before discharge. Sixty patients were included from the ED, the intervention was completed before discharge for 50 patients (83%), and 39 (61.5% male; median age 80 years) completed the follow-up 30 days after discharge. The median MAI score decreased from 14 (IQR 8-20) at admission to 8 (IQR 2-13) 30 days after discharge (p < 0.001). The number of patients with an AOU score ≥1 was reduced from 36% to 10% (p < 0.001). Thirty days after discharge, 83% of the changes were sustained and for 28 patients (72%), 1≥ medication had been deprescribed. In conclusion, a collaborative medication review and deprescribing intervention is feasible to perform in the ED.
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Medication reviews with pharmacist and/or geriatrician involvement can improve medication appropriateness measures.
“Medication reviews with pharmacist and/or geriatrician involvement can improve medication appropriateness measures, 49”
From Factors associated with recurrent emergency department visits among people living with dementia: A retrospective cohort study (2023) · cites this paper as [49]
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- Authors
- Houlind, M. B., Andersen, A. L., Treldal, C., Jørgensen, L. M., Kannegaard, P. N., Castillo, L. S., Christensen, L. D., Tavenier, J., Rasmussen, L. J. H., Ankarfeldt, M. Z., Andersen, O., & Petersen, J.
- Affiliations
- University of Copenhagen (DK)
- Amager Hospital (DK)
- Herlev Hospital (DK)
- Bispebjerg Hospital (DK)
- Duke University (US)
- Corresponding author
- Houlind, Morten Baltzer
- ORCID
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2020-01-27
- Volume
- 9
- Issue
- 2
- Pages
- 348
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC7074203
- OpenAlex
- W3001653910
- Cited by
- 48
- References
- 57
- Citations by year
- 2026: 11 · 2025: 4 · 2024: 5 · 2023: 9 · 2022: 6 · 2021: 12 · 2020: 1
- FWCI
- 3.67
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Scopus (Elsevier) (submittedVersion, cc-by)
- Funders
- Gentofte Hospital
- Lundbeckfonden (R288-2018–380)
- Region Hovedstaden
- H. Lundbeck A/S
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Keywords
- medication review, deprescribing, polypharmacy, older adults, emergency department, potentially inappropriate prescribing, STOPP criteria, renal dosing, Medication Appropriateness Index, feasibility, inappropriate prescribing
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