NCT05616689

Bundled Hyperpolypharmacy Deprescribing

Bundled Hyperpolypharmacy Deprescribing: Implementation and Evaluation of a System-wide Quality Improvement Intervention

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 2,471 (actual)
• Sponsor: Kaiser Permanente · Academic / Other
• Sex: All
• Age: 76 Years
• Healthy volunteers: Accepted

Summary

Older patients using many prescription drugs (hyperpolypharmacy) may be at increased risk of adverse drug effects. This randomized controlled trial tested the effectiveness and safety of a quality intervention intended to reduce hyperpolypharmacy. The study was set at Kaiser Permanente Northern California, an integrated health system with multiple pre-existing deprescribing workflows. Eligible patients were aged ≥76 years using ≥10 prescription medications. The intervention included physician-pharmacist collaborative drug therapy management, standard-of-care practice recommendations, shared decision-making, and deprescribing protocols administered by telephone over multiple cycles for a maximum of 180 days after allocation. A priori primary effectiveness endpoints included change in the number of medications and in the prevalence of geriatric syndrome from 181-365 days after allocation. Second endpoints included utilization and adverse drug withdrawal effects. Information was obtained from the electronic health record.

Conditions

• Polypharmacy

Interventions

Type	Name	Description
OTHER	Bundled hyperpolypharmacy	Bundled hyperpolypharmacy playbook to be used by pharmacist, with physician approval, in shared decision making with participant,

Timeline

• Start date: 2020-10-19
• Primary completion: 2022-07-29
• Completion: 2023-05-24
• First posted: 2022-11-15
• Last updated: 2023-12-15

Locations

1 site across 1 country: United States