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- W2731731610 abstract "Deprescribing has been proposed as a way to reduce polypharmacy in frail older people, and may improve their survival. We have conducted two randomised controlled trials (RCT) and a systematic review examining deprescribing, the planned cessation of potentially non-beneficial medicines. In our pilot RCT in 35 participants we found that an RCT of deprescribing is acceptable to participants, and that recruitment in residential aged care facilities (RACF) is feasible. In an open RCT enrolling ninety-five people aged over 65 years living in four RACF we found that randomisation to the deprescribing intervention was associated with participants taking 2.0 ± 0.9 (95%CI 0.08 to 3.8, p = 0.04) fewer medicines after 12 months. Twelve (of 47) intervention participants and 19 (of 48) control participants died within 12 months of randomisation (26% versus 40% mortality, p = 0.16, HR 0.60, 95%CI 0.30 to 1.22). The main limitations of this study were the open design and small participant numbers. Systematic review of the available randomised data suggests that reducing polypharmacy does not have a significant effect on mortality (OR 0.82, 95% CI 0.61 to 1.11). However subgroup analysis suggests patient specific interventions (as opposed to generalized educational programmes) may be associated with a significant reduction in mortality (OR 0.62, 95% CI 0.43 to 0.88). Deprescribing appears to reduce the number of regular medicines consumed by older people with, at least, no significant adverse effects on survival." @default.
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- W2731731610 date "2017-06-30" @default.
- W2731731610 modified "2023-09-23" @default.
- W2731731610 title "DEPRESCRIBING IN FRAIL OLDER PEOPLE" @default.
- W2731731610 doi "https://doi.org/10.1093/geroni/igx004.3509" @default.
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