More than 20% of adults aged 65 and older living in the community are taking 10 or more medications. With every added pill, the chance of developing a complication from a medication increases, and side effects can impact on quality of life, appetite, energy, or even lead to hospital visits. Older adults living in aged care facilities, as well as their family members and caretakers, are interested in deprescribing unnecessary medications that may be causing undesirable side effects. This involves periodically reviewing and stopping pills after considering a patient's past medical history, along with their current health and values- a process which takes time and resources. Our group has previously developed an electronic application, MedSafer, which partly automates the process in hospitalized patients.
The current project will determine if MedSafer is also helpful in deprescribing in community-dwelling adults. The study will take place in four Canadian care facilities across Canada. Medications and past medical history, including a measure of frailty, will be electronically cross-referenced in order to generate a list of deprescribing opportunities for the treating team. Opportunities are prioritized, and when needed contain instructions for stopping medications gradually. We will see if MedSafer helps to successfully stop medications in the aged care facility environment and will further automate the data entry process. Patients, families, and the treating team will be surveyed to determine positive impacts on health, quality of life, sleep, energy and mood. We will explore which deprescribing opportunities have the strongest impact in terms of number of pills stopped, the prevention of harmful outcomes, and associated costs. The result will be a fully scalable electronic deprescribing intervention, a new standard of care, that can be applied quarterly at aged care facilities across Quebec and Canada.