Research into de-prescribing medications among elderly people has, so far in the pilot randomized controlled trial, been receptive.
The trial, which involved 15 participants who understood the concept of de-prescribing, saw one selected drug withdrawn or significantly reduced over a two-month period without complications.
The medications targeted in the study varied, but are commonly used among older people. They included: anti-hyptension, anti-angina, diuretics or pain relief medication. On average, they counted as one of nine taken daily by each participant prior to the study’s commencement.
Patients in the trial were made up of volunteers from aged-care facilities, where they stayed to be carefully monitored during the withdrawals.
Geriatrician and WA Centre for Health and Ageing clinical pharmacologist Professor Christopher Beer said that with the frailer older patients, they have the highest risk of reoccurring events.
“The last thing you want to do is withdraw someone’s medication and then precipitate a return of symptoms,” Professor Beer said.
He said the reason behind the research is uncertainty as to whether medicine prescriptions continue to be appropriate and safe when consumed along with other prescribed and over-the-counter drugs over extensive time periods.
Professor Beer said the notion of de-prescribing seems acceptable to GPs and specialist physicians, who, at present, start their patients’ on medication without a focus on when and how to stop the treatment in future.
“We think a [follow-up] blinded RCT is essential because of the potential bias around open medication use,” he said.
Since the pilot trial, Professor Beer has received National Health and Medical Research Council funding to start the blinded RCT called Opti-Med.
The research aims to provide the evidence on when de-prescribing as an acceptable medical intervention can be used. Professor Beer said that unlike the initial study, the current blinded randomized control trial now underway will have the power to investigate the effect of de-prescribing on clinical outcomes and quality of life.
Both the risks and benefits of reducing medication among an increasingly large ageing population will be evaluated as the trials continue.
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