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Article

A Collaborative Medication Review Including Deprescribing for Older Patients in an Emergency Department: A Longitudinal Feasibility Study

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Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark
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The Capital Region Pharmacy, 2730 Herlev, Denmark
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Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark
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Department of Geriatric Medicine, Copenhagen University Hospital Herlev and Gentofte, 2900 Hellerup, Denmark
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Department of Geriatrics, Copenhagen University Hospital Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark
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Research Unit for General Practice, 8000 Aarhus, Denmark
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Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA
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Copenhagen Phase IV unit (Phase4CPH), Center of Clinical Research and Prevention and Department of Clinical Pharmacology, Copenhagen University Hospital Bispebjerg and Frederiksberg, 2000 Copenhagen, Denmark
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Emergency Department, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark
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Section of Biostatistics, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(2), 348; https://doi.org/10.3390/jcm9020348
Received: 27 December 2019 / Revised: 22 January 2020 / Accepted: 24 January 2020 / Published: 27 January 2020
(This article belongs to the Section Pharmacology)
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. View Full-Text
Keywords: medication review; deprescribing; Medication Appropriateness Index; potentially inappropriate medication; polypharmacy; clinical pharmacy; geriatric; emergency department medication review; deprescribing; Medication Appropriateness Index; potentially inappropriate medication; polypharmacy; clinical pharmacy; geriatric; emergency department
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MDPI and ACS Style

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. A Collaborative Medication Review Including Deprescribing for Older Patients in an Emergency Department: A Longitudinal Feasibility Study. J. Clin. Med. 2020, 9, 348. https://doi.org/10.3390/jcm9020348

AMA Style

Houlind MB, Andersen AL, Treldal C, Jørgensen LM, Kannegaard PN, Castillo LS, Christensen LD, Tavenier J, Rasmussen LJH, Ankarfeldt MZ, Andersen O, Petersen J. A Collaborative Medication Review Including Deprescribing for Older Patients in an Emergency Department: A Longitudinal Feasibility Study. Journal of Clinical Medicine. 2020; 9(2):348. https://doi.org/10.3390/jcm9020348

Chicago/Turabian Style

Houlind, Morten B., Aino L. Andersen, Charlotte Treldal, Lillian M. Jørgensen, Pia N. Kannegaard, Luana S. Castillo, Line D. Christensen, Juliette Tavenier, Line J.H. Rasmussen, Mikkel. Z. Ankarfeldt, Ove Andersen, and Janne Petersen. 2020. "A Collaborative Medication Review Including Deprescribing for Older Patients in an Emergency Department: A Longitudinal Feasibility Study" Journal of Clinical Medicine 9, no. 2: 348. https://doi.org/10.3390/jcm9020348

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