Polypharmacy Intervention More Widely Adopted

The project developed and evaluated consumer information leaflets for older hospital patients and their carers to support the deprescribing of unnecessary antipsychotics, benzodiazepines and proton pump inhibitors on hospital discharge.

Following completion of a pilot study at Balmain Hospital, the leaflets have become amongst the most popular downloadable resources for clinicians on the NSW Therapeutics Advisory Group website. They are also now part of a package of medication review interventions which will be trialled in Sydney hospitals as part of an NHMRC-funded project to improve quality use of medicines for patients with frailty in hospitals.

Professor Sarah Hilmer and her team from Northern Sydney Local Health District (NSLD) refined the content of the leaflets via an iterative co-design process involving consumers, carers and hospital health professionals at NSLHD and Sydney Local Health District.

The information encourages a reduction in the use of unnecessary prescription drugs by older Australians. Known as inappropriate polypharmacy, the problem is associated with an increase in falls and injuries amongst older people.

“Over time, many older Australians accumulate prescriptions to the point where they are using some medications that are no longer necessary for them,” said Professor Hilmer, who is the Head of the Department of Clinical Pharmacology at Royal North Shore Hospital and Conjoint Professor of Geriatric Pharmacology at the University of Sydney’s Northern Clinical School.

“When the cumulative burden of those prescribed drugs begins to impair function it’s time to look and see which ones can be discontinued. But sometimes decisions made in hospital to withdraw unnecessary drugs are not clearly understood by patients and the intended changes are not implemented well after discharge. That’s where our deprescribing brochures have proven useful.”

Professor Hilmer and fellow Sydney Health Partners researchers Professors David Hunter and Manuela Ferreira are also developing a version of the consumer leaflets to support deprescribing of opioids taken for chronic musculoskeletal pain.