Evaluation of pharmacist-led physician-supported inpatient deprescribing model in older patients admitted to an acute general medical unit

Objective To evaluate the need for and the feasibility of a pharmacist-led physician-supported deprescribing model. Methods All patients aged >= 65 years, with polypharmacy, admitted to the acute general medical unit (GMU) of an Australian tertiary hospital over a 6-week period were prospectively evaluated for deprescribing by team pharmacists. Clinical decision-making was supported by physicians. Results One hundred and twenty-nine patients met inclusion criteria, and 58 (45%) were identified for deprescribing. Ninety-two (7.2%) deprescribing instances were identified of 1277 medications prescribed. Of these, 46 (50%) were successfully deprescribed during inpatient admission in 35 (60%) patients. The most prevalent rationale for deprescribing was "harm outweighing benefits." Outpatient deprescribing was planned in 16 (17%) of instances, and 39 (42%) would require outpatient follow-up to ensure adherence to recommendations and safety. No predictors for deprescribing were identified on univariate analyses. Conclusions A pharmacist-led physician-supported deprescribing model is feasible in GMU patients who have polypharmacy.