(B-056) Implementation and Evaluation of Deprescribing Among Patients with Polypharmacy in Tertiary Care Hospital

Background: Deprescribing serves as an established management strategy for minimizing polypharmacy and potentially inappropriate medications. The main goal of deprescribing is to improve patient outcomes and minimize the adverse outcomes that are associated with inappropriate medications and polypharmacy.

Objectives: To implement and evaluate deprescribing among patients with Polypharmacy.

Methods: This study was a prospective interventional study conducted at JSS Hospital to implement deprescribing in patients with polypharmacy. Patients aged >18 years, prescribed five or more medications during hospitalization, were included after obtaining informed consent. Daily reviews of patient records were performed to identify potentially inappropriate medications (PIMs) based on established deprescribing criteria. The deprescribing process involved evaluating medication necessity, assessing risk-benefit profiles, and consulting prescribers for decision-making. Medications deemed inappropriate due to adverse drug reactions (ADRs), drug-drug interactions, duplication, improper dosing, or lack of indication were considered for deprescribing. Ethical approval was obtained from the Institutional Ethics Committee, ensuring patient confidentiality and adherence to ethical standards. This study aimed to optimize medication use and enhance patient safety through a structured deprescribing approach.

Results: In a cohort of 247 patients, 193 patients were identified as being on polypharmacy, with an average of 10.63 medications per patient. A total of 59 potentially inappropriate medications (PIMs) were identified and targeted for deprescribing interventions based on risk-benefit assessments. The categories of medications identified as PIMs included:
Antibiotics and Antivirals (14), Gastrointestinal Drugs (17), NSAIDs (5), Anticoagulants (3), Corticosteroids (3), Diuretics (4), Anticonvulsants (1) and Antipsychotics (1), Anthelminthics (1), Antihypertensives (4), Vitamin supplements (2), Antihistamines (1), Silodosin (1), Acebrophylline (1), Thyroxine sodium (1).
Common Drug-Related Problems (DRPs) Identified were: Drug interactions (5), ADR (7), Drug use without indication (5), improper drug selection (10), improper dose selection (9), improper frequency selection (3), improper duration of therapy (11), Drug duplication (9).

Conclusions: Deprescribing interventions in polypharmacy patients effectively reduced potentially inappropriate medications (PIMs), minimizing adverse drug reactions and drug-related problems. A structured deprescribing approach optimized medication use and enhanced patient safety.